Chest
Selected ReportsIdiopathic Bronchiolitis Obliterans With Organizing Pneumonia: An Acute and Life-Threatening Syndrome
Section snippets
Case 1
A 62-year-old woman presented to the emergency room with shortness of breath of 6 months’ duration, which had worsened over the last 2 to 3 days before admission. Fever and weight loss exceeding 20 lb were also reported. The patient denied cough, orthopnea, and paroxysmal nocturnal dyspnea. Her past medical history included diabetes mellitus, hypertension, and congestive heart failure for which she was taking insulin, fosinopril, furosemide, and potassium supplements. She had an 80 pack-year
The Clinical Picture
Signs and symptoms reported by our patients were nonspecific, constitutional, and mild (Table 2). Dyspnea was the most common complaint and was exertional in one instance. Cough productive of scanty whitish sputum was reported by four patients. All diagnostic studies done on bronchial secretions were uninformative. Pleuritic chest pain was observed in one patient. There was no associated pleural effusion or pneumothorax. Different patterns of radiologic pictures emerged and included diffuse,
Discussion
Bronchiolitis obliterans with organizing pneumonia secondary to viral infections, toxic exposures, the use of certain medications, cocaine abuse, and HIV infection has been clearly described in the literature.9, 10, 11 The idiopathic variety of this entity, however, was only first described in 1985 by Epler et al.1 Careful history and relevant investigations are required to differentiate the idiopathic variety of BOOP from the secondary causes of BOOP, which were just mentioned. Idiopathic
References (11)
- et al.
Idiopathic bronchiolitis obliterans organizing pneumonia
Chest
(1989) Diffuse pulmonary infiltrates and respiratory failure following 2 weeks of dyspnea in a 45-year-old woman
Chest
(1993)- et al.
Bronchiolitis obliterans organizing pneumonia
N Engl J Med
(1985) - et al.
Cryptogenic organizing pneumonitis
Chest
(1992) - et al.
BOOP in Europe
Chest
(1992)
Cited by (109)
Organizing Pneumonia
2021, Encyclopedia of Respiratory Medicine, Second EditionPathology of Idiopathic Interstitial Pneumonias
2020, Surgical Pathology ClinicsCitation Excerpt :This situation can provide the radiological reversed halo sign in HRCT (Fig. 11E). According to case reports, there are some OP cases with worse prognosis.80–82 On histology, some cases show marked fibrin along with OP83 and are called acute fibrinous OP.
Idiopathic interstitial pneumonias
2019, Difficult to Diagnose Rare Diffuse Lung DiseaseUrgent Lung Transplantation in Severe Acute Respiratory Failure Based on Rapidly Progressive Interstitial Lung Disease: A Case Report
2017, Transplantation ProceedingsCitation Excerpt :This meant 0.5% of all idiopathic interstitial pneumonias. In general, this form of interstitial lung disease is thought to have better prognosis; however, in fewer than 6% of cases, it can be a fulminant disease, an acute and life-threatening form presenting with adult respiratory distress syndrome [10,11]. Our patient did not show any improvement to high-dose glucocorticoid therapy, and because of the detected irreversible structural changes on CT scans, neither cyclophosphamide nor mycophenolate was added to her regimen.
Cicatricial variant of cryptogenic organizing pneumonia
2017, Human PathologyCitation Excerpt :CCOP was associated with a nodular pattern of radiographic infiltration and with persistence of these infiltrates despite therapy, in contrast to classical COP. Between 10% and 20% of patients with COP have progressive disease, with some rare cases having a fulminant course that terminates in the adult respiratory distress syndrome/diffuse alveolar damage [13,20,22-24]. A poor outcome in COP has been tied clinically to patients with underlying immunologic disorders especially autoimmune disease, severe hypoxemia, prior tobacco use, and bronchoalveolar lavage demonstrating increased eosinophils and neutrophils [21,25-28].
Cryptogenic organizing pneumonia
2016, Revue des Maladies Respiratoires