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[Persistent infiltrative pulmonary disease]
B Boersema1, H R Peeters, J M Broekman
1Bosch Medicentrum, locatie Groot Ziekengasthuis, afd. Longziekten, Postbus 90.153, 5200 ME 's-Hertogenbosch.
Nederlands Tijdschrift Voor Geneeskunde
|June 5, 2001
Summary
Bronchiolitis obliterans organizing pneumonia (BOOP) can present as persistent lung abnormalities. Prompt diagnosis via VATS biopsy and high-dose corticosteroid treatment lead to good outcomes for BOOP patients.
Area of Science:
- Pulmonology
- Pathology
Background:
- Persistent infiltrative lung abnormalities on chest X-rays can pose diagnostic challenges.
- Bronchiolitis obliterans organizing pneumonia (BOOP) is a pathological-anatomical entity often presenting with non-specific pulmonary symptoms.
Observation:
- Two patients, a 63-year-old woman and a 64-year-old man, presented with pulmonary complaints and persistent infiltrative lung abnormalities.
- Initial diagnostic analyses were inconclusive; however, video-assisted thoracoscopic surgery (VATS) biopsies revealed BOOP.
- One patient had rapidly progressive BOOP unresponsive to antibiotics, while the other developed BOOP secondary to rheumatoid arthritis.
Findings:
- BOOP is a nonspecific excessive repair response to various stimuli including infections, drugs, and autoimmune diseases, or can be idiopathic.
- High-resolution CT scans aid in differentiating BOOP from other interstitial lung diseases.
- Open lung biopsy via VATS is crucial for definitive BOOP diagnosis.
Implications:
- BOOP requires consideration in the differential diagnosis of persistent infiltrative lung disease.
- Treatment with high-dose oral corticosteroids (e.g., prednisone 1 mg/kg/day) is effective.
- Adequate and timely treatment of BOOP generally leads to a favorable prognosis.
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