Bronchiolitis obliterans organizing pneumonia: experience at three hospitals in Riyadh

Because reports of bronchiolitis obliterans organizing pneumonia (BOOP) are lacking from the Middle East, we conducted a retrospective review of of all histopathologically proven cases of BOOP over a 10-year period at three tertiary care hospitals in Riyadh and describe the clinical features and out...

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Bibliographic Details
Published in:Annals of Saudi medicine 2007-01, Vol.27 (1), p.32-35
Main Authors: Alsaghir, Abdullah H, Al-Mobeireek, Abdullah F, Al-Jahdali, Hamdan, Al-Eithan, Abdulsalam, Al-Otair, Hadil, Al-Dayel, Fouad
Format: Article
Language:English
Subjects:
Adult
Aged
Biopsy
Cough
Cryptogenic Organizing Pneumonia - diagnosis
Dyspnea
Female
Fever
Hospitals, University
Humans
Lung - diagnostic imaging
Male
Middle Aged
Original
Radiography
Respiratory Function Tests
Respiratory Sounds
Retrospective Studies
Saudi Arabia - epidemiology
Treatment Outcome
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Summary:Because reports of bronchiolitis obliterans organizing pneumonia (BOOP) are lacking from the Middle East, we conducted a retrospective review of of all histopathologically proven cases of BOOP over a 10-year period at three tertiary care hospitals in Riyadh and describe the clinical features and outcome. Charts at the three hospitals were searched using a specific code for BOOP or cryptogenic organizing pneumonia (COP). Lung specimens had to show histological proof of BOOP with a compatible clinical picture. Chest radiographs and high-resolution CT scans were reviewed. Twenty cases of biopsy-proven BOOP had well-documented clinical and radiographic data. There were 11 males and 9 females (mean age, 58 years; range, 42-78). The clinical presentation of BOOP was acute or subacute pneumonia-like illness with cough (85%), fever (70%) dyspnea, (85%) and crackles (80%). The most frequent radiological pattern was a bilateral alveolar infiltrate. The most common abnormality on pulmonary function testing (n=14) was a restrictive pattern (11 patients). Most patients (70%) had no underlying cause (idiopathic BOOP). Other associations included thyroid cancer, rheumatoid arthritis, syphilis and Wegner's granulomatosis. Ten patients (50%) had a complete response to steroids, 6 (30%) had a partial response and 3 (15.8%) with secondary BOOP had rapid progressive respiratory failure and died. The clinical presentation of BOOP in our patients is similar to other reported series. A favorable outcome occurs in the majority of cases. However, BOOP may occasionally be associated with a poor prognosis, particularly when associated with an underlying disease.
ISSN:0256-4947
0975-4466
DOI:10.5144/0256-4947.2007.32