[Bronchiolitis obliterans organizing pneumonia. Review of six cases].
BACKGROUND
Bronchiolitis obliterans with organizing pneumonia (BOOP) is recently described clinicopathological entity, with only a few series of patients reported. Terminology is unclear, which together with its rarity lead to a poor understanding of the entity.


OBJECTIVE
To review the clinical, radiological, and laboratory features and the response to therapy in cases of BOOP in our environment.


METHODS
A total of 463 lung biopsies were obtained at Móstoles Hospital, Madrid, from 1992 to 1994. In six cases the anatomo-pathological diagnosis was BOOP. Clinical histories of these patients were reviewed.


RESULTS
Six patients were diagnosed with BOOP. From these six patients, four (66%) were female, with a mean age of 59 years (45-74 years). Three patients (50%) were smokers. BOOP was idiopathic in four cases (66%) and secondary to rheumatoid arthritis in one (17%) and Legionella pneumonia in another patient (17%). Patients presented with cough and dyspnea (100%), chest pain and constitutional syndrome (66%) and fever (34%) of one to eight weeks evolution. Laboratory data included: increased ESR (100%), abnormal levels of liver enzymes (83%), hypoxemia (83%) and abnormal spirometry (50%). Radiological studies demonstrated alveolar infiltrates in 83%, predominantly in lower lobes, which were of a migratory nature in 33%. CT, performed in five patients, demonstrated alveolar infiltrates in all patients, which were bilateral and peripheric in two. Transbronchial biopsy was diagnostic in five cases, and in one patient thoracotomy had to be performed. One patient died (17%); the remaining patients (83%) improved with steroids, although 34% relapsed. Mean follow-up time was eleven months (5-24 months).


CONCLUSIONS
BOOP observed in our environment is a rare entity, usually of an idiopathic nature, which presents with characteristic clinical course and laboratory findings. Transbronchial biopsy is diagnostic in many patients. The clinical course is good with steroids in most patients, although relapses are common.
Garay
J B
JB
Servicio de Medicina Interna, Hospital de Móstoles, Madrid.
Zurdo
M R
MR
López
O A
OA
Gaviria
A Z
AZ
Medina
L V
LV
Delgado
E G
EG
Entrecanales
M V
MV
Galiana
J R
JR
D000368:Aged; D001706:Biopsy; D018549:Cryptogenic Organizing Pneumonia / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012129:Respiratory Function Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed
Bronquiolitis obliterante con neumonía organizativa. Revisión de seis casos.