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Acute Fibrinous and Organizing Pneumonia (AFOP) in Children: A Case Report and Literature Review
Mohammed AlZaid1, Ahmed AlEidan2, Wajd AlThakfi3
1Paediatric Pulmonology and Sleep Medicine Department, Children's Specialised Hospital, King Fahad Medical City, Riyadh, Saudi Arabia.
Insights
Acute Fibrinous and Organizing Pneumonia (AFOP) is a rare pediatric lung disease. Early recognition and treatment with corticosteroids and azithromycin improved outcomes in a 3-year-old boy.
Area of Science:
- Pediatric Pulmonology
- Rare Lung Diseases
- Diagnostic Challenges in Pediatrics
Background:
- Acute Fibrinous and Organizing Pneumonia (AFOP) is a rare lung injury characterized by intra-alveolar fibrin deposition.
- While primarily seen in adults, AFOP can affect children, mimicking common respiratory illnesses and posing diagnostic difficulties.
- Etiological factors include infections, autoimmune disorders, and drug reactions.
Observation:
- A 3-year-old boy with a history of wheezing presented with persistent hypoxemia and lung opacities.
- Initial asthma-like treatment was ineffective; high-resolution CT revealed diffuse lung abnormalities.
- Bronchoalveolar lavage identified Haemophilus influenzae, and lung biopsy confirmed AFOP.
Findings:
- The pediatric patient diagnosed with AFOP showed significant clinical and radiographic improvement after treatment with corticosteroids and azithromycin.
- This case underscores the importance of considering AFOP in children with persistent, atypical respiratory symptoms.
Implications:
- Highlights the need for increased pediatrician awareness of pediatric AFOP due to limited literature.
- Emphasizes the critical role of early diagnosis and tailored treatment for improving outcomes in pediatric AFOP.
- Suggests further case reports are necessary to elucidate the clinical course and optimize management strategies for AFOP in children.
Introduction:
Acute Fibrinous and Organizing Pneumonia (AFOP) is a rare lung disease that presents with acute lung injury characterized by intra-alveolar fibrin deposition. Although primarily described in adults, AFOP can occur in children and may mimic common respiratory illnesses, posing a diagnostic challenge. The condition can result from various etiological factors, including infections, autoimmune disorders, and drug reactions. The purpose of this case is to highlight the clinical presentation, diagnostic challenges and management strategies of this rare and underrecognized pediatric condition. By describing this case we aim to raise awareness among pediatricians given the limited literature on pediatric AFOP to aid in recognizing and tailoring treatment in order to improve outcomes.
Methods And Materials:
Patient's data were collected retrospectively from medical records, including clinical notes, laboratory results, imaging studies, and histopathological findings, where applicable. Informed written consent was obtained and signed from parents of the child for the use of his medical information for educational and publication purposes, ensuring confidentiality and anonymity.
Results:
We present the case of a 3-year-old boy with a history of recurrent viral-induced wheezing, initially treated for asthma-like symptoms until he developed persistent hypoxemia. Despite targeted therapy, the patient exhibited persistent respiratory symptoms and consolidative opacities in the right lung. A high-resolution computed tomography (HRCT) scan showed diffuse lung abnormalities, prompting further evaluation. Bronchoscopy with bronchoalveolar lavage revealed Haemophilus influenzae infection, and an open lung biopsy confirmed AFOP. The patient was treated with corticosteroids and azithromycin, leading to significant clinical and radiographic improvement.
Conclusion:
This case highlights the importance of considering AFOP in pediatric patients with atypical and persistent respiratory symptoms. Early diagnosis and intervention are crucial for managing this rare condition. Further case reports are needed to better understand AFOP's clinical course and optimize treatment strategies in pediatric populations.
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