Journal of

Case Reports and Images in Medicine

 
   
Case Report
 
A case of cryptogenic organizing pneumonia in a patient with idiopathic thrombocytopenic purpura
Alfredo De Giorgi1, Marco Fiore2, Federico Moro1, Michele Domenico Spampinato1, Fabio Fabbian1
1MD, Department of Medical Sciences, Clinica Medica, University of Ferrara, University Hospital St. Anna, Ferrara, Italy
2MS, Department of Medical Sciences, Clinica Medica, University of Ferrara, University Hospital St. Anna, Ferrara, Italy

Article ID: 100039Z09AG2017
doi:10.5348/Z09-2017-39-CR-11

Address correspondence to:
Fabio Fabbian, MD
Department of Medical Sciences, Clinica Medica
University of Ferrara, University Hospital St. Anna
Via Aldo Moro 8, 44124 Cona (Ferrara)
Italy

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How to cite this article
De Giorgi A, Fiore M, Moro F, Spampinato MD, Fabbian F. A case of cryptogenic organizing pneumonia in a patient with idiopathic thrombocytopenic purpura. J Case Rep Images Med 2017;3:39–41.

Abstract


Introduction: Cryptogenic organized pneumonia (COP) or bronchiolitis obliterans-organizing pneumonia (BOOP) is clinical condition characterized by interstitial lung disease with loss of functioning parenchyma due to inflammatory damage and pulmonary fibrosis. We report a case of COP related to autoimmune condition in patients with idiopathic thrombocytopenic purpura (ITP) and diabetes mellitus type 1.
Case Report: A 46-year-old deaf and mute male was admitted to our hospital for general sickness, severe dyspnea. He had a history of ITP started 20 years before, previous splenectomy, smoking, systemic hypertension, diabetes mellitus type 1, glaucoma, previous admission for pulmonary thromboembolism. High resolution computed tomography (HRCT) found diffuse interstitial thickening with a bilateral ground-glass opacification, emphysematous areas, left-lower-lobe consolidation (apparently due to passive atelectasis because of left elevation of diaphragm and hiatal hernia), bundle-like thickening areas, a micronodule and clear reversed atoll sign. He was treated with corticosteroids obtaining progressive improvement of thrombocytopenia and pulmonary distress.
Conclusion: Association between ITP and COP or BOOP could be ascribed to autoimmune derangement. Respiratory symptoms and imaging in patients with ITP could suggest association with COP or BOOP. However, both conditions might ameliorate with corticosteroid treatment.

Keywords: Atoll sign, Bronchiolitis obliterans-organizing pneumonia, Cryptogenic organized pneumonia, Idiopathic thrombocytopenic purpura


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Acknowledgement
This paper is supported (in part) by a scientific institutional grant (Fondo Ateneo Ricerca –FAR), University of Ferrara, Italy.

Author Contributions
Alfredo De Giorgi – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Marco Fiore – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Federico Moro – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Michele Domenico Spampinato – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Fabio Fabbian – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2017 Alfredo De Giorgi. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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