Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report

Abstract Background Acute fibrinous and organizing pneumonia (AFOP) is a rare lung condition that is associated with acute lung injury. Its etiology may be idiopathic or secondary to a series of conditions, including immune-related diseases, unclassified connective tissue diseases, hematopoietic ste...

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Autores principales:	Xiaojing Wu, Kejing Wang, Yayue Gao, Ying Cai, Wenqiao Wang, Dingrong Zhong, Qingyuan Zhan
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Chronic active Epstein-Barr virus infection Acute fibrinous and organizing pneumonia Hemophagocytic lymphohistiocytosis Consolidation in lung Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/0b54a4e603d14cd3ae623a6dfdd27a6f
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spelling	oai:doaj.org-article:0b54a4e603d14cd3ae623a6dfdd27a6f2021-12-05T12:26:11ZAcute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report10.1186/s12879-021-06868-01471-2334https://doaj.org/article/0b54a4e603d14cd3ae623a6dfdd27a6f2021-12-01T00:00:00Zhttps://doi.org/10.1186/s12879-021-06868-0https://doaj.org/toc/1471-2334Abstract Background Acute fibrinous and organizing pneumonia (AFOP) is a rare lung condition that is associated with acute lung injury. Its etiology may be idiopathic or secondary to a series of conditions, including immune-related diseases, unclassified connective tissue diseases, hematopoietic stem cell transplantation, infections, hematological diseases and drug induced lung toxicity. We report for the first time a case of AFOP complicated with hemophagocytic lymphohistiocytosis (HLH) caused by chronic active Epstein-Barr virus (CAEBV) infection. Case presentation A 64-year-old man was admitted with a complaint of fever and dyspnea for 2 weeks. The patient presented with elevated serum aminotransferase levels, splenomegaly, progressive decrease of red blood cells and platelets, hyperferritinemia, hypofibrinogenemia, and elevated of Soluble interleukin-2 receptor (sCD25). His chest computed tomography (CT) scan revealed multiple patchy consolidation in both lungs and multiple lymphadenopathy in the mediastinum and hilum. The serology for antibodies of VCA-IgG was positive, EBV-DNA in peripheral blood was elevated, and EBV nucleic acid was detected in the alveolar lavage fluid. Histopathology of the lung tissue showed a dominant of intra-alveolar fibrin and organizing pneumonia. Hemophagocytic cells was found in the bone marrow smear and biopsy. EBV-DNA was detected in lung tissue and bone marrow using in situ hybridization with an EBV-encoded RNA (EBER) probe. After 50 days of hospitalization, he was improved in lung and hemogram. Conclusion We report a case of AFOP with HLH caused by CAEBV in an immunocompetent adult, suggesting that AFOP may be a rare but serious complication caused by CAEBV, and glucocorticoid therapy may improve short-term prognosis.Xiaojing WuKejing WangYayue GaoYing CaiWenqiao WangDingrong ZhongQingyuan ZhanBMCarticleChronic active Epstein-Barr virus infectionAcute fibrinous and organizing pneumoniaHemophagocytic lymphohistiocytosisConsolidation in lungInfectious and parasitic diseasesRC109-216ENBMC Infectious Diseases, Vol 21, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Chronic active Epstein-Barr virus infection Acute fibrinous and organizing pneumonia Hemophagocytic lymphohistiocytosis Consolidation in lung Infectious and parasitic diseases RC109-216
spellingShingle	Chronic active Epstein-Barr virus infection Acute fibrinous and organizing pneumonia Hemophagocytic lymphohistiocytosis Consolidation in lung Infectious and parasitic diseases RC109-216 Xiaojing Wu Kejing Wang Yayue Gao Ying Cai Wenqiao Wang Dingrong Zhong Qingyuan Zhan Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report
description	Abstract Background Acute fibrinous and organizing pneumonia (AFOP) is a rare lung condition that is associated with acute lung injury. Its etiology may be idiopathic or secondary to a series of conditions, including immune-related diseases, unclassified connective tissue diseases, hematopoietic stem cell transplantation, infections, hematological diseases and drug induced lung toxicity. We report for the first time a case of AFOP complicated with hemophagocytic lymphohistiocytosis (HLH) caused by chronic active Epstein-Barr virus (CAEBV) infection. Case presentation A 64-year-old man was admitted with a complaint of fever and dyspnea for 2 weeks. The patient presented with elevated serum aminotransferase levels, splenomegaly, progressive decrease of red blood cells and platelets, hyperferritinemia, hypofibrinogenemia, and elevated of Soluble interleukin-2 receptor (sCD25). His chest computed tomography (CT) scan revealed multiple patchy consolidation in both lungs and multiple lymphadenopathy in the mediastinum and hilum. The serology for antibodies of VCA-IgG was positive, EBV-DNA in peripheral blood was elevated, and EBV nucleic acid was detected in the alveolar lavage fluid. Histopathology of the lung tissue showed a dominant of intra-alveolar fibrin and organizing pneumonia. Hemophagocytic cells was found in the bone marrow smear and biopsy. EBV-DNA was detected in lung tissue and bone marrow using in situ hybridization with an EBV-encoded RNA (EBER) probe. After 50 days of hospitalization, he was improved in lung and hemogram. Conclusion We report a case of AFOP with HLH caused by CAEBV in an immunocompetent adult, suggesting that AFOP may be a rare but serious complication caused by CAEBV, and glucocorticoid therapy may improve short-term prognosis.
format	article
author	Xiaojing Wu Kejing Wang Yayue Gao Ying Cai Wenqiao Wang Dingrong Zhong Qingyuan Zhan
author_facet	Xiaojing Wu Kejing Wang Yayue Gao Ying Cai Wenqiao Wang Dingrong Zhong Qingyuan Zhan
author_sort	Xiaojing Wu
title	Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report
title_short	Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report
title_full	Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report
title_fullStr	Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report
title_full_unstemmed	Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report
title_sort	acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active epstein-barr virus infection: a case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/0b54a4e603d14cd3ae623a6dfdd27a6f
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Acute fibrinous and organizing pneumonia complicated with hemophagocytic lymphohistiocytosis caused by chronic active Epstein-Barr virus infection: a case report

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