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Background <p>Organizing pneumonia (OP) is a rare interstitial lung disease characterized by intra-alveolar fibroblastic plugs and chronic inflammation. Although most cases are idiopathic, OP may occur secondary to infections, autoimmune disease, or drug exposure. Pulmonary complications of tumor necrosis factor-alpha (TNF-α) inhibitors are uncommon, and infliximab-associated OP has not yet been described in the pediatric population.</p> Case presentation <p>A 12-year-old girl with ulcerative colitis (UC) on infliximab presented with three weeks of dyspnea, fever, and pleuritic chest pain. Computed tomography (CT) revealed bilateral peripheral infiltrates. Microbiologic testing and bronchoalveolar lavage were negative. Wedge biopsy demonstrated fibroblastic plugs (Masson bodies), consistent with OP. Infliximab was discontinued. The patient’s symptoms improved without corticosteroids, with near-complete radiologic resolution at 2 months.</p> Conclusions <p>This case highlights probable infliximab-associated OP in a pediatric patient, highlighting a need for awareness of rare pulmonary toxicities from biologics. Importantly, resolution occurred without corticosteroids, suggesting that withdrawal of the offending agent may suffice in select cases.</p>

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Organizing pneumonia potentially caused by infliximab in a pediatric patient with ulcerative colitis

  • 期刊论文

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  • 发表日期：

    2026年3月14日

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  • Brian Lee,
  • Isaac Martin,
  • Kevin Bax,
  • Samira Jeimy

摘要

Background

Organizing pneumonia (OP) is a rare interstitial lung disease characterized by intra-alveolar fibroblastic plugs and chronic inflammation. Although most cases are idiopathic, OP may occur secondary to infections, autoimmune disease, or drug exposure. Pulmonary complications of tumor necrosis factor-alpha (TNF-α) inhibitors are uncommon, and infliximab-associated OP has not yet been described in the pediatric population.

Case presentation

A 12-year-old girl with ulcerative colitis (UC) on infliximab presented with three weeks of dyspnea, fever, and pleuritic chest pain. Computed tomography (CT) revealed bilateral peripheral infiltrates. Microbiologic testing and bronchoalveolar lavage were negative. Wedge biopsy demonstrated fibroblastic plugs (Masson bodies), consistent with OP. Infliximab was discontinued. The patient’s symptoms improved without corticosteroids, with near-complete radiologic resolution at 2 months.

Conclusions

This case highlights probable infliximab-associated OP in a pediatric patient, highlighting a need for awareness of rare pulmonary toxicities from biologics. Importantly, resolution occurred without corticosteroids, suggesting that withdrawal of the offending agent may suffice in select cases.