ArticleAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology2026
Organizing pneumonia potentially caused by infliximab in a pediatric patient with ulcerative colitis.
Article in Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundOrganizing 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.
conclusionsThis 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.
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