Bronchiolitis obliterans organizing pneumonia : Experience at three hospitals in Riyadh

• Main Authors: Alsaghir Abdullah, Al-Mobeireek Abdullah, Al-Jahdali Hamdan, Al-Eithan Abdulsalam, Al-Otair Hadil, Al-Dayel Fouad
• Format: Article
• Language: English
• Published: King Faisal Specialist Hospital and Research Centre 2007-01-01
• Series: Annals of Saudi Medicine
• Online Access: http://www.saudiannals.net/article.asp?issn=0256-4947;year=2007;volume=27;issue=1;spage=32;epage=35;aulast=Alsaghir

<b>Background: </b> 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. <b> Methods: </b> Charts at the three hospitals were searched using a specific code for BOOP or cryptogenic orga-nizing 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. <b> Results: </b> 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&#x0025;), fever (70&#x0025;) dyspnea, (85&#x0025;) and crackles (80&#x0025;). 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&#x0025;) had no underlying cause (idio-pathic BOOP). Other associations included thyroid cancer, rheumatoid arthritis, syphilis and Wegner&#x2032;s granulo-matosis. Ten patients (50&#x0025;) had a complete response to steroids, 6 (30&#x0025;) had a partial response and 3 (15.8&#x0025;) with secondary BOOP had rapid progressive respiratory failure and died. <b>Conclusion: </b> 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.