Clinical analysis on 33 patients with cryptogenic organizing pneumonia_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

XIA Degang ^* , YANG Changyu ^* , XIA Wei ^* , CHEN Guangfeng ^* ,  ZHANG Yingwei

Department of Respiratory Medicine, Drum Tower Hospital Affiliated to Nanjing University Medical College, Nanjing, Jiangsu 210008, P. R. China;

Corresponding?author：

ZHANG Yingwei, Email: yingwei16@aliyun.com

Keywords：

Cryptogenic organizing pneumonia; Lung biopsy; High resolution CT

DOI：

10.7507/1671-6205.201711011

Video：

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ObjectiveTo improve clinicians' awareness of cryptogenic organizing pneumonia (COP).MethodsThirty-three inpatients with COP, who had been diagnosed by pathology in Nanjing Drum Tower Hospital during January 2013 to December 2016 were collected. Their clinical manifestations, laboratory tests and imaging data were reviewed and analyzed retrospectively.ResultsThirty-three cases consisted of 18 males and 15 females, and the mean age was (58.7±13.5) years old. Most patients had subacute or insidious onset. The common symptoms were cough, fever, shortness of breath and chest tightness. About half of patients revealed inspiratory crackles or velcroes. Autoantibodies and anti-neutrophil cytoplasmic antibodies were negative. High-resolution computerized tomography findings of COP included bilateral patchy areas of air-space consolidation that showed predominantly subpleural or peri-bronchovascular distribution, focal nodules, enlarged hilar or mediastinal lymph nodes and pleural effusion. 25 patients were treated with glucocorticoid, 6 with macrolid, and 2 were only followed up without drug treatment.ConclusionsClinical manifestations, laboratory tests and imaging features are important clues to diagnose COP. Diagnosis depends on pathology. Meanwhile, definite pathogen and potential underlying diseases must be excluded.

Citation： XIA Degang, YANG Changyu, XIA Wei, CHEN Guangfeng, ZHANG Yingwei. Clinical analysis on 33 patients with cryptogenic organizing pneumonia. Chinese Journal of Respiratory and Critical Care Medicine, 2018, 17(5): 461-464. doi: 10.7507/1671-6205.201711011 Copy

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1. American Thoracic Society, European Respiratory Society. American Thoracic Society/European Respiratory Society International Multidisciplinary Consensus Classification of the Idiopathic Interstitial Pneumonias. This Joint Statement of the American Thoracic Society (ATS), and the European Respiratory Society (ERS) was adopted by the ATS board of directors, June 2001 and by the ERS Executive Committee, June 2001. AmJ Respir Crit Care Med, 2002, 165(2): 277-304.
2. Epler GR. Bronchiolitis obliterans organizing pneumonia. Arch Intern Med, 2001, 161(2): 158-164.
3. Epler GR, Colby TV, Mc Loud TC, et al. Bronchiolitis obliterans organizing pneumonia. N Engl J Med, 1985, 312(3): 152-158.
4. Cordier JF. Cryptogenic organizing pneumonia. Clin Chest Med, 2004, 25(4): 727-738.
5. 蔡后榮, 李惠萍. 實用間質性肺疾病. 北京: 人民衛生出版社, 2010, 98-111.
6. 蔡后榮, 侯杰. 隱源性機化性肺炎的臨床、病理和影像學診斷. 中國醫學影像技術, 2005, 21(7): 1133-1136.
7. 施舉紅, 許文兵, 劉鴻瑞, 等. 隱源性機化性肺炎 18 例的臨床病理特征. 中華肺結核和呼吸雜志, 2006, 29(3): 167-170.
8. Schlesinger C, Koss MN. The organizing pneumonia: an update and review. Curr Opin Pulm Med, 2005, 11(5): 422-430.
9. Bradley B, Branley HM, Egan JJ, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax, 2008, 63(Suppl 5): v1-v58.
10. Pathak V, Kuhn JM, Durham C, et al. Macrolide use leads to clinical and radiological improvement in patients with cryptogenic organizing pneumonia. Ann Am Thorac Soc, 2014, 11(1): 87-91.
11. Shitenberg D, Fruchter O, Fridel L, Kramer MR. Successful rituximab therapy in steroid-resistant, cryptogenic organizing pneumonia: a case series. Respiration, 2015, 90(2): 155-159.
12. Oymak FS, Demirbas HM, Mavili E, et al. Bronchiolitis obliterans organizing pneumonia. Clinical and roentgeuological features in 26 cases. Respiration, 2005, 72(3): 254-262.

Chinese Journal of Respiratory and Critical Care Medicine

Clinical analysis on 33 patients with cryptogenic organizing pneumonia

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