Cincotta Domenic R, Sebire Neil J, Lim Emma, Peters Mark J
Paediatric and Neonatal Intensive Care Unit, Great Ormond Street Hospital for Children, NHS Trust, London, UK.
Pediatr Crit Care Med. 2007 Jul;8(4):378-82. doi: 10.1097/01.PCC.0000269375.10806.60.
The histopathologic pattern of acute fibrinous and organizing pneumonia (AFOP) has been described recently in cases of acute respiratory distress syndrome (ARDS) in adults and differs from the well-recognized pattern of classic diffuse alveolar damage (DAD). The objective of this study was to determine whether similar appearances can be seen in infant ARDS.
Case report and retrospective review of infant lung biopsies 1995-2005.
Paediatric and neonatal intensive care units in a tertiary referral center.
None.
None.
A formerly premature infant with ARDS secondary to respiratory syncytial virus pneumonitis had histopathologic features of AFOP on open lung biopsy. Nine infants from 1995 to 2005 had definite histology of DAD or AFOP and fulfilled American-European Consensus Conference criteria for the diagnosis of ARDS. Of these, classic DAD findings were present in seven, whereas two had features of AFOP and DAD. Features suggesting viral infection were identified in five infants.
The histopathologic features of AFOP may be seen in some cases of infant ARDS. The variability in the histopathology of ARDS raises questions as to the pathogenesis and clinical correlates of these different patterns.
急性纤维素性机化性肺炎（AFOP）的组织病理学模式最近在成人急性呼吸窘迫综合征（ARDS）病例中得到描述，且不同于公认的经典弥漫性肺泡损伤（DAD）模式。本研究的目的是确定在婴儿ARDS中是否能看到类似表现。
1995 - 2005年婴儿肺活检的病例报告及回顾性分析。
一家三级转诊中心的儿科和新生儿重症监护病房。
无。
无。
一名因呼吸道合胞病毒肺炎继发ARDS的早产儿在开胸肺活检中有AFOP的组织病理学特征。1995年至2005年的9名婴儿有明确的DAD或AFOP组织学表现，并符合欧美共识会议ARDS诊断标准。其中，7名有经典DAD表现，而2名有AFOP和DAD特征。5名婴儿发现有提示病毒感染的特征。
在一些婴儿ARDS病例中可能会出现AFOP的组织病理学特征。ARDS组织病理学的变异性引发了关于这些不同模式的发病机制及临床相关性的问题。
