PubMed · 11042243
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S D Liao, P J Akin. 2000-10-15. Diagnostic dilemma.. https://doi.org/10.1016/s0002-9343(00)00565-9
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We present the case of a renal transplant patient on sirolimus (rapamycin) therapy who developed cryptogenic organizing pneumonia in association with Pneumocystis carinii infection. To our knowledge, such a case has not been previously reported.
Organising pneumonia is defined histopathologically by intra-alveolar buds of granulation tissue, consisting of intermixed myofibroblasts and connective tissue. Although nonspecific, this histopathological pattern, together with characteristic clinical and imaging features, defines cryptogenic organising pneumonia when no cause or peculiar underlying context is found. Rapid clinical and imaging improvement is obtained with corticosteroid treatment, but relapses are common after stopping treatment.
We report the case of a woman with membranoproliferative glomerulonephritis type I who presented with acute respiratory failure secondary to alveolar haemorrhage. The persistence of the respiratory failure, once the alveolar haemorrhage had ceased, was apparently due to diffuse alveolar damage in organization. The recognition of this proliferative reaction through the performance of transbronchial biopsy allowed the initiation of a correct treatment with which a favourable response was obtained.