Bronchiolitis Obliterans Organizing Pneumonia
Also Know As Cryptogenic Organizing Pneumonia (COP)
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Bronchiolitis obliterans organizing pneumonia
Bronchiolitis Obliterans Organizing Pneumonia (BOOP) is a rare inflammatory lung disease. Patients experience simultaneous inflammation of the bronchioles and of the alveolar lung spherical units. Bronchiolitis obliterans refers to swirls or plugs of fibrous, granulation tissue filling the small bronchiole airways while Organizing pneumonia refers to organized swirls of inflammatory tissue filling the small spherical units of the lungs called alveoli and the alveolar ducts.[1] The disease is also known as cryptogenic organizing pneumonia (COP).[2]
Causes
Most cases are idiopathic or with unknown cause. BOOP is usually reported as a secondary phenomenon in several other clinical settings.[3] Some forms are associated with infections such as chlamydia, influenza or malaria. The risk of developing BOOP is heightened for individuals who have diseases such as lupus, rheumatoid arthritis or scleroderma. Researches also reveal that people who have received certain types of chemotherapy or radiation to their chest as well as those who received transplants sometimes develop BOOP. Medications linked to BOOP include cocaine, gold salts, some antibiotics and anti-seizure medications.[2] Many industrial toxins and environmental pollutants have also been associated with BOOP. BOOP has also been reported in conditions like primary biliary cirrhosis Evans syndrome and chronic sinusitis, lung cancer, lung atelectasis, asthma, cystic fibrosis, secondary amyloidosis and after coronary artery bypass graft surgery. [3]
Symptoms
People of all ages can be affected. In about half of the cases, patients present with influenza-like illness followed by a short illness lasting for a few months characterized by a persistent nonproductive cough, shortness of breath, low-grade fever, malaise and weight loss. Rarely, there may be pleuritic chest pain and coughing of blood. [3]
Diagnosis
Medical history is obtained and physical examination is done. Lung biopsy is still the preferred method for establishing the diagnosis. Conventional radiography and High Resolution Computed Tomography (HRCT) serve as a guide for additional investigation and the site of lung biopsy. [3]
Treatment
BOOP may resolve by its own. Current standard of treatment is corticosteroid. Majority of patients recover with treatment. Symptoms resolve within days or weeks and radiographic findings show improvement in 50-86% of patients. In a minority of patients, the disease may persist. Relapse may occur when the patient withdraws treatment. Most patients have total and permanent recovery. [3]
References:
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http://www.webmd.com/lung/bronchiolitis-obliterans-organizing-pneumonia
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http://www.mayoclinic.com/health/bronchiolitis-obliterans/AN00307
- http://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2008;volume=3;issue=2;spage=67;epage=75;aulast=Al-Ghanem
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