title: Bronchiolitis obliterans organizing pneumonia: experience at three hospitals in Riyadh.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: Abdullah H
authors.initials: AH
authors.lastname: Alsaghir
authors.forename: Abdullah F
authors.initials: AF
authors.lastname: Al-Mobeireek
authors.forename: Hamdan
authors.initials: H
authors.lastname: Al-Jahdali
authors.forename: Abdulsalam
authors.initials: A
authors.lastname: Al-Eithan
authors.forename: Hadil
authors.initials: H
authors.lastname: Al-Otair
authors.forename: Fouad
authors.initials: F
authors.lastname: Al-Dayel
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D003371:Cough; D018549:Cryptogenic Organizing Pneumonia / Q000175:diagnosis*; D004417:Dyspnea; D005260:Female; D005334:Fever; D006785:Hospitals, University; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D016896:Treatment Outcome