title: [Clinical characters of rapidly progressive crytogenic organizing pneumonia].
abstract: OBJECTIVE
  To explore the clinical features of rapidly progressive crytogenic organizing pneumonia (COP).
  
  
  METHODS
  Nine cases of rapidly progressive COP with acute respiratory failure confirmed by lung biopsy at First Affiliated Hospital, Nanjing Medical University from October 2003 to March 2014 were retrospectively reviewed.
  
  
  RESULTS
  There were 5 males and 4 females with an age range of (52.1 ± 11.4) years. The onset of illness was 7-20 days. The major manifestations included cough (n = 9), dyspnea (n = 9), fever (n = 7), hypodynamia (n = 6), weight loss (n = 3), night sweat (n = 2), hemoptysis (n = 1), cyanosis (n = 9), "velcro" crackles (n = 6) and moist rales (n = 3). Blood tests showed elevated levels of erythrocyte sedimentation rate (n = 8), C-reactive protein (n = 8) and serum ferritin (n = 6). The results of blood gas analysis indicated acute respiratory failure in all 9 patients (PaO2<60 mmHg, 1 mmHg = 0.133 kPa). Chest computed tomography showed bilateral and multiple distribution, patchy areas of alveolar consolidation with air bronchograms (n = 5), diffuse ground-glass opacity (n = 4), tractional bronchiectasis (n = 2), pleural effusion (n = 2) and spontaneous pneumothorax (n = 1). Six cases were cured by conventional dose corticosteroid and another 3 by large-dose methylprednisolone (240 mg/d). Two cases relapsed and then recovered after a second corticosteroid therapy.
  
  
  CONCLUSIONS
  The clinical manifestations of rapidly progressive COP show severe inflammatory reactions with a fast progression. Chest computed tomography depicts extensive lesions along with pleural effusion and spontaneous pneumothorax. Conventional dose of corticosteroid is the first choice therapy for rapidly progressive COP. Large-dose methylprednisolone is needed when conventional dose of corticosteroid proves ineffective.
authors.affiliation: Department of Respiratory Disease, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China. Email: xiongbinjiang@126.com.
authors.forename: Xiongbin
authors.initials: X
authors.lastname: Jiang
authors.affiliation: Department of Respiratory Disease, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Respiratory Disease, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Yao
authors.affiliation: Department of Respiratory Disease, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Xuefan
authors.initials: X
authors.lastname: Cui
authors.affiliation: Department of Respiratory Disease, First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, China.
authors.forename: Mao
authors.initials: M
authors.lastname: Huang
mesh_terms: D001706:Biopsy; D002097:C-Reactive Protein; D003371:Cough; D020732:Cytogenetic Analysis; D018450:Disease Progression; D004417:Dyspnea; D005260:Female; D005334:Fever; D006469:Hemoptysis; D006801:Humans; D008297:Male; D008775:Methylprednisolone; D008875:Middle Aged; D010996:Pleural Effusion; D011014:Pneumonia; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D002097:C-Reactive Protein; D008775:Methylprednisolone