Cryptogenic Organizing Pneumonia: A Series of 25 Cases

Abstract

Introduction: Cryptogenic Organizing Pneumonia (COP) earlier known as 'Bronchiolitis Obliterans with Organizing Pneumonia' (BOOP), is a rare lung condition in which the bronchioles, alveoli and the walls of small bronchi become inflamed and plugged with connective tissue. The condition is called "cryptogenic" because the cause is unknown. Aim: To study clinical and radiological spectrum of cases reported as COP. Materials and Methods: This is an observational study including secondary data analysis. The medical records, clinical and radiological profiles of COP patients, visiting Dr. Hedgewar Hospital, Aurangabad (2016-2019) were analyzed. Result: The Study included 25 cases. The urban: rural ratio was 14:11. Male: Female ratio was 14:11. The presenting symptoms were mainly Progressive dyspnoea (72%) and Dry cough (68%). Co-morbidities were observed in 72% patients and 28% patients required assisted ventilation. The radiological features were bilateral patchy opacities in 36%, unilateral consolidation in 24%, reticulo-nodular opacities in 8% patients. 32% of Chest Xray were reported as normal. HRCT Lung showed Ground Glass Opacities in 44%, Sub pleural And Interstitial Thickening in 23%, Multiple Nodular Enhancements in 14%, Cystic Changes and Traction Bronchiectasis in 15% and Others (Crazy paving, cavitory changes) in 4% patients. Steroids were administered in 48% patients. The mortality was 20%. The survivors (80% patients) showed clinical improvement. Elderly population, co-morbidities, smoking and ventilator support were the high risk factors for the outcome. Conclusion: COP has varied clinico-radiological spectrum. A high index of suspicion will lead to proper diagnosis and management resulting in better outcome. The steroid therapy resulted in better outcome.