Mentions: The patient was given 80 mg prednisone daily, but his clinical status continued to deteriorate, with worsening rhabdomyolysis. Echocardiography showed normal left ventricular function. Chest computed tomography (CT) showed worsening patchy infiltrates bilaterally (Figure 3A). Fiber optic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy ruled out superimposed infections and diffuse alveolar hemorrhage. Histopathology of the lung biopsy revealed acute fibrinous and organizing pneumonia (Figure 4). Intravenous immunoglobulin therapy (2 g/kg body weight) and intravenous methylprednisolone were initiated. In the following weeks the patient’s strength improved, and creatine kinase levels decreased to 450 IU/L. He was discharged on a tapering dose of prednisone along with oral mycophenolate. At the 1-month follow-up visit, chest radiograph (Figure 1B) and chest CT (Figure 3B) showed complete resolution of bilateral infiltrates. The patient’s weakness and muscular pain improved considerably, and he was able to function normally. His creatinine kinase levels were in the normal range at 1-month follow-up. The patient attends monthly follow-up at our pulmonary and rheumatology clinic. He is on a tapering dose of prednisone.
Patient: male, 34"/>