Case Report: Nebulized autologous platelet-rich plasma associated with quantitative CT and clinical changes in a patient with COPD and chronic hypersensitivity pneumonitis.

Background: Chronic obstructive pulmonary disease (COPD) and chronic hypersensitivity pneumonitis are characterised by progressive structural lung damage, declining respiratory function, and limited regenerative treatment options. Platelet-rich plasma (PRP) possesses anti-inflammatory and regenerative properties; however, its pulmonary application remains largely unexplored. Case presentation: A 70-year-old man with a longstanding history of COPD and chronic hypersensitivity pneumonitis underwent eight treatments with nebulized autologous PRP at approximately 4-week intervals. In this observational case report, changes during the treatment period were assessed using serial clinical CT imaging with quantitative analysis, pulmonary function testing, home peak expiratory flow (PEF) and patient-reported outcomes. Results: At follow up, qCT demonstrated a decrease in low attenuation area percentage (LAA%) from 17.4% to 13.6%, representing a 22% relative reduction, accompanied by an 11.5% reduction in total inspiratory lung volume. Formal spirometry PEF increased by approximately 20% compared to the most recent pre-treatment assessment, with similar increases observed on home PEF monitoring. The patient also reported marked reductions in exertional dyspnea, substantially improved walking tolerance, and increased energy levels. Nebulized PRP was well tolerated, with no adverse events attributed to treatment. Conclusion: To our knowledge, this is the first report describing serial qCT assessment alongside physiological and patient-reported outcomes following nebulized autologous PRP in an individual with COPD and chronic hypersensitivity pneumonitis. Although causality cannot be established from a single case, the findings across multiple outcome domains warrant further investigation in prospectively designed studies.