[Clinical manifestations of organizing pneumonia]

Medicina (B Aires). 2016;76(6):338-342.
[Article in Spanish]

Abstract

Organizing pneumonia is a clinical entity asociated with nonspecific symptoms and radiological findings and abnormalities in pulmonary function tests. It is defined by the characteristic histopathological pattern: filling of alveoli and respiratory bronchioles by plugs of granulation tissue. It can be idiopathic (COP) or secondary to other causes (SOP). It is an unusual finding and the clinical and radiographic findings are nonspecific. For specific diagnosis an invasive procedure has to be done, but often empirical treatment is started when there's a clinical suspicion. We describe the clinical characteristics of 13 patients with histological diagnosis of organizing pneumonia. Data was obtained from their medical records. The median age was 76 years and the median time to diagnosis from the onset of symptoms was 31 days. In 10 cases the diagnosis was made by transbronchial biopsy. 8 patients required hospitalization, 4 of them received high doses of steroids and 3 required ventilatory support. One patient died from a cause attributable to this entity and 5 relapsed. Dyspnea, cough and fever were the most frequent symptoms. Most patients had more than one tomographic pattern being the most common ground glass opacities and alveolar consolidation. Nine patients were diagnosed with COP and 4 with SOP. The most frequent underlying cause of SOP was drug toxicity. The clinical characteristics of the reported cases are consistent with previously published series. As an interesting feature, there was a group of patients that needed high doses of steroids and ventilatory support.

Keywords: bronchiolitis obliterans organizing pneumonia; cryptogenic organizing pneumonia.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Cough / etiology
  • Cryptogenic Organizing Pneumonia / complications
  • Cryptogenic Organizing Pneumonia / diagnostic imaging
  • Cryptogenic Organizing Pneumonia / drug therapy
  • Cryptogenic Organizing Pneumonia / pathology*
  • Dyspnea / etiology
  • Female
  • Fever / etiology
  • Humans
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Male
  • Middle Aged
  • Thoracoscopy
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult

Substances

  • Adrenal Cortex Hormones