title: Factors associated with the relapse of cryptogenic and secondary organizing pneumonia.
abstract: BACKGROUND
  Organizing pneumonia (OP) is a histopathological response pattern to lung inflammation. It is clinically classified into cryptogenic OP and secondary OP, which is associated with various clinical conditions. Rapid resolution with corticosteroids and frequent relapses are common in OP. However, few studies have investigated the factors associated with OP relapse.
  
  
  METHODS
  The medical records of 75 patients with biopsy-proven OP, diagnosed between January 2010 and August 2015, who underwent corticosteroid therapy were retrospectively reviewed. Initially, the patients were all treated successfully; however, 31 patients experienced relapse thereafter (R group), whereas the others did not (NR group; 44 patients). The clinical, radiological, and pathological characteristics and administered corticosteroid doses were compared between the two groups.
  
  
  RESULTS
  The neutrophil percentage in the bronchoalveolar lavage (BAL) fluid and the level of fibrin deposition in lung biopsy specimens were higher in the R group than in the NR group (P=0.01 and P=0.002, respectively). The multivariate analysis demonstrated that both factors were statistically significant predictors of OP relapse.
  
  
  CONCLUSIONS
  A high neutrophil percentage in the BAL and the level of fibrin deposition in lung biopsy specimens are considered predictive factors of OP relapse during the tapering or after the cessation of steroid therapy. Patients without these findings may be treated with low-dose corticosteroids.
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: yonishi@hmj-net.hosp.go.jp.
authors.forename: Yasutaka
authors.initials: Y
authors.lastname: Onishi
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: kawa-t@hmj-net.hosp.go.jp.
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Kawamura
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: nakahary@hmj-net.hosp.go.jp.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Nakahara
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: ryogo@hmj-net.hosp.go.jp.
authors.forename: Ryogo
authors.initials: R
authors.lastname: Kagami
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: sasakis@hmj-net.hosp.go.jp.
authors.forename: Shin
authors.initials: S
authors.lastname: Sasaki
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: syk19860203@gmail.com.
authors.forename: Sayaka
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: k8181@hmj-net.hosp.go.jp.
authors.forename: Ryota
authors.initials: R
authors.lastname: Kominami
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: katsu614@hmj-net.hosp.go.jp.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Hirano
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: rhiraoka@hmj-net.hosp.go.jp.
authors.forename: Ryota
authors.initials: R
authors.lastname: Hiraoka
authors.affiliation: Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-shi, Hyogo 670-8520, Japan. Electronic address: nhirata@hmj-net.hosp.go.jp.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Hirata
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D000369:Aged, 80 and over; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology; D018549:Cryptogenic Organizing Pneumonia / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D005337:Fibrin / Q000378:metabolism*; D005544:Forecasting; D006801:Humans; D007958:Leukocyte Count; D008168:Lung / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D005337:Fibrin
keywords: Bronchoalveolar lavage; Corticosteroid; Fibrin; Neutrophilia; Organizing pneumonia