Bronchiolitis Obliterans Organizing Pneumonia Associated with Systemic Lupus Erythematosus

Gammon, R B; Bridges, Tracy; Al-Nezir, Hussein; Alexander, Charles Bruce; Kennedy, John I.

doi:10.1378/chest.102.4.1171

Cited by 100 publications

(49 citation statements)

References 20 publications

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“…which have been previously described in association with SLE [7,21] and with rheumatoid arthritis [22], was demonstrated in any of our patients [23]. Lymphadenopathy was identified in six of our patients.…”

Section: Ct Of Thorax Shows Bilateral Pleural Thickening (Arrows)supporting

confidence: 69%

High-resolution chest CT in systemic lupus erythematosus.

Fenlon¹,

Doran²,

Sant³

et al. 1996

American Journal of Roentgenology

205

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Section: Ct Of Thorax Shows Bilateral Pleural Thickening (Arrows)supporting

confidence: 69%

High-resolution chest CT in systemic lupus erythematosus.

Fenlon¹,

Doran²,

Sant³

et al. 1996

American Journal of Roentgenology

205

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“…In these cases, the development of lung cysts should suggest the diagnosis of LIP [158][159][160]. Finally, the clinicoradiological syndrome of OP characterised by patchy alveolar infiltrates has been described in patients with SLE [161][162][163].…”

Section: Radiological Featuresmentioning

confidence: 99%

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement

Antoniou¹,

Margaritopoulos²,

Economidou³

et al. 2009

European Respiratory Journal

148

122

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The connective tissue disorders (CTDs), also called collagen vascular diseases (CVDs), represent a heterogeneous group of immunologically mediated inflammatory disorders with a large variety of affected organs. Individuals with a CTD (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, polymyositis/dermatomyositis and mixed connective tissue disease) are susceptible to respiratory involvement. When the lungs are affected, an increasing mortality and morbidity in CVDs occurs. Interstitial lung disease (ILD) is established as a clinical corollary across the spectrum of CTDs, with an overall incidence estimated at 15%.Therefore, pivotal clinical dilemmas remain in the evaluation and management of ILD involvement in CVDs. Critical questions are the presence of fibrosis and whether the disease is clinically significant. Moreover, the clinician has to decide if treatment is warranted and which is the best therapeutic approach. The use of additional tests, such as pulmonary function tests, high-resolution computed tomography scan, bronchoalveolar lavage fluid and surgical lung biopsy, deserves better discussion. The present review focuses on establishing the diagnosis of ILD in CTD, and on evaluating disease activity and prognosis. This will provide the basis for therapeutic decisions that will be discussed, including an overview of recent advances.

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“…Histologically, it is characterized by patchy inflammatory changes in the bronchi and alveolar lumina and walls, an interstitial mononuclear cell infiltrate of variable density, obliteration of the airway lumen by intraluminar polyps of loose connective tissue containing inflammatory cells and fibroblasts and patchy areas of organizing pneumonia [10,11]. Although the majority of BOOP cases are idiopathic, the syndrome has been described in association with many different settings, particularly collagen vascular disease [10,12], and drugs [8]. It has also been described in the context of resolving infection, organizing diffuse alveolar damage, hypersensitivity pneumonitis, exposure to toxic fumes, organizing aspiration pneumonia, eosinophilic pneumonia, eosinophilic granuloma, Wegener's granulomatosis and around other lesions, including abscesses and tumours [13±15].…”

Section: Discussionmentioning

confidence: 99%

Left bronchial isomerism, normal atrial arrangement and bronchomalacia mimicking asthma: a new syndrome?

Bush¹

1999

Eur Respir J

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T-cell chronic lymphocytic leukaemia with pulmonary involvement and relapsing BOOP. E Vaiman, M Odeh, D Attias, Y Ben-Arie, A Oliven. #ERS Journals Ltd 1999. ABSTRACT: We report on a case of T-cell chronic lymphocytic leukaemia involving the lung, with clinical, radiological and histological evidence of relapsing bronchiolitis obliterans-organizing pneumonia in a 70-yr-old female. Pulmonary disease was the major clinical manifestation of this chronic lymphocytic leukaemia. The first two episodes of the patient's pulmonary disorder resolved without treatment, and the third episode was treated with cytotoxic agents as part of the leukaemia treatment regimen. Two additional episodes of the pulmonary disorder occurred; both responded to prednisone. Eur Respir J 1999; 14: 471±474.Keywords: Bronchiolitis obliterans-organizing pneumonia pulmonary involvement T-cell chronic lymphocytic leukaemia Received: December 4 1997 Accepted after revision March 3 1998 Pulmonary involvement in chronic lymphocytic leukaemia (CLL) is reported to be present at autopsy in up to 40% of cases [1]. However, clinical symptoms are uncommon, and significant pulmonary involvement as the major manifestation of CLL has rarely been reported [1±4]. All previously described cases were associated with B-cell-CLL (B-CLL) [1±4]. Only one of them was associated with bronchiolar involvement [2], and no case of bronchiolitis obliteransorganizing pneumonia (BOOP) associated with CLL has previously been reported. Here, we describe the case of a patient with a mixed pulmonary involvement of T-cell CLL (T-CLL) and relapsing BOOP. Case reportA 70-yr-old female was admitted with a 3-month history of progressive dyspnoea, particularly on exertion, and a nonproductive cough without fever. In the previous few days, mild haemoptysis had also developed. Six months previously, she had been diagnosed as having CLL, on the basis of marked peripheral lymphocytosis (leukocyte count 16,000 cells . mm -3 , 80% lymphocytes) with a characteristic peripheral blood smear. She had no history of asthma, and was a lifelong nonsmoker. Her other medical history was unremarkable, except for mild hypertension which was treated with hydrochlorothiazide. Chest radiography before admission was normal, and the patient was diagnosed by her family physician as having bronchitis. Treatment with antibiotics, cough mixtures and bronchodilators by means of inhalers was unsuccessful.Physical examination showed tachypnoea (28 breaths . min ; her body temperature and the results of the throat examination were normal. Lung examination revealed bilateral diffuse scanty wheezing and bibasilar inspiratory crackles. A few mildly enlarged lymph nodes were palpated bilaterally in the neck. The results of the heart and abdominal examination were normal with no hepatomegaly or splenomegaly.The haemoglobin concentration was 12.8 g . dL -1, leukocyte count 18,000 . mm -3 (72% lymphocytes) with no eosinophilia, platelet count 20,7000 . mm -3 and lactate dehydrogenase activity 380 IU .). The chest rad...

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Bronchiolitis Obliterans Organizing Pneumonia Associated with Systemic Lupus Erythematosus

Cited by 100 publications

References 20 publications

High-resolution chest CT in systemic lupus erythematosus.

High-resolution chest CT in systemic lupus erythematosus.

Pivotal clinical dilemmas in collagen vascular diseases associated with interstitial lung involvement

Left bronchial isomerism, normal atrial arrangement and bronchomalacia mimicking asthma: a new syndrome?

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