Clinical characters of rapidly progressive crytogenic organizing pneumonia

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.

Medienart:

Artikel

Erscheinungsjahr:

2014

Erschienen:

2014

Enthalten in:

Zur Gesamtaufnahme - volume:94

Enthalten in:

Zhonghua yi xue za zhi - 94(2014), 42 vom: 18. Nov., Seite 3319-22

Sprache:

Chinesisch

Beteiligte Personen:

Jiang, Xiongbin [VerfasserIn]
Zhao, Xin [VerfasserIn]
Yao, Xin [VerfasserIn]
Cui, Xuefan [VerfasserIn]
Huang, Mao [VerfasserIn]

Themen:

9007-41-4
C-Reactive Protein
Journal Article
Methylprednisolone
X4W7ZR7023

Anmerkungen:

Date Completed 08.09.2015

Date Revised 02.12.2018

published: Print

Citation Status MEDLINE

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM245669558