Bronchiolitis obliterans organizing pneumonia in a patient with Behçet's disease.
A 55-year-old male presented a productive cough, haemoptysis, and intermittent fever for 2 weeks. He was diagnosed as having Behcet's disease (BD) with manifestations of recurrent oral ulcers, genital ulcers, erythema nodosum, a gastro/duodenal ulcer, colon ulcers, and folliculitis. After admission, a chest X-ray showed bilateral ill-defined patches. Subsequent chest computerized tomography revealed multiple patchy consolidations over the left and right lower lobes. Because of poor response to oxacillin antibiotic treatment, an open lung biopsy was arranged. Bronchiolitis obliterans organizing pneumonia (BOOP) was diagnosed. Methylprednisolone pulse therapy, followed by prednisolone and cyclophosphamide maintenance, was prescribed. The patient responded well, with clinical and radiological resolution. Early diagnosis with proper treatment is crucial in the management of this lethal pulmonary disease.
Ning-Sheng
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Sections of Allergy, Immunology, Rheumatology, Department of Medicine, DaLin Tzu Chi Buddhist Hospital, Taiwan, ROC. nslai@airpa.org.tw
Chun-Liang
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Ray-Sheng
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D001528:Behcet Syndrome / Q000150:complications* / Q000175:diagnosis*; D001707:Biopsy, Needle; D018549:Cryptogenic Organizing Pneumonia / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D013902:Radiography, Thoracic; D018570:Risk Assessment; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D003520:Cyclophosphamide; D011239:Prednisolone; D008775:Methylprednisolone