Cryptogenic Organizing Pneumonia with Sarcoidosis Overlap: An Atypical Case Study

Case Reports in Medicine
Ajmal Nazir NeelambraSowmya Sundararajan

Abstract

We present a case of a young female with subacute symptoms of cough and progressive dyspnoea. On evaluation, the patient was diagnosed as cryptogenic organizing pneumonia based on her histopathological reports. However, her significant elevation of serum angiotensin-converting enzyme (SACE) levels which drop after treatment with oral steroids, relapse, and clinical presentation pointed towards sarcoidosis as clinical diagnosis. Here, in this patient, transbronchial biopsy was suggestive of cryptogenic organizing pneumonia along with chest X-ray, and the HRCT finding was also favouring the same. But in this case, we have also seen elevated levels of serum ACE which dropped significantly to the normal level along with a complete clearance of lesions with systemic steroids, and this favours sarcoidosis. Also, the recurrence was in different areas of the lung, and lesions once again responded both clinically and radiologically to steroids with a consistent drop in serum angiotensin-converting enzyme (SACE) levels, which again is a feature common in sarcoidosis. In COP, often complete clearance of the lesions is seldom seen, even though they do respond to steroids but not as dramatically as in our case. Also, recurrence of the lesio...Continue Reading

References

Jan 17, 1985·The New England Journal of Medicine·G R EplerE A Gaensler
Aug 2, 2006·The European Respiratory Journal·J-F Cordier
Sep 25, 2012·Seminars in Respiratory and Critical Care Medicine·Vincent Cottin, Jean-François Cordier

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Methods Mentioned

BETA
ESR
X-ray
lavage
biopsies
biopsy

Software Mentioned

GeneXpert

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