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KMID : 0390320190290010025
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Chungbuk Medical Journal
2019 Volume.29 No. 1 p.25 ~ p.32
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Cryptogenic organizing pneumonia progressed to fatal acute respiratory distress syndrome
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Kim Sun-Hyung
Shin Yoon-Mi
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Abstract
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Cryptogenic organizing pneumonia (COP) is a one of the idiopathic interstitial pneumonia showing acute or subacute progression. The main symptoms are cough, dyspnea and fever with an average duration of 3 months or less. The most common finding in chest computed tomography (CT) is bilateral consolidations of subpeural and air bronchogram mainly in lower lung area. Histopathologic finding of organizing pneumonia is the presence of buds of granulation tissue consisting of fibroblasts-myoblasts embedded in connective tissue. Current standard treatment of COP is corticosteroids, the prognosis is known to be generally good. Therefore, a good prognosis is expected when steroid treatment is started and clinical symptoms improve. There is non-responder to steroids and who showed rapid progression leading to respiratory failure or death is reported to be within 5% and extremely rare according to literature. We experienced recently a rare case that a COP patient who died despite applying mechanical ventilation (MV) and extracorporeal membrane oxygenation (ECMO) due to acute respiratory distress syndrome (ARDS). Herein we report this case and review the literature.
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KEYWORD
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Cryptogenic organizing pneumonia, Acute respiratory distress syndrome, Death
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