The Drug-Induced Respiratory Disease Website
(Fr: Pneumopathie organisée (BOOP). See also under If and XVc. Exclusion of an infection is crucial, Typically, wandering areas of consolidation on imaging. Note of CAUTION: several recent publications described OP cases without lung pathology being documented. Basically, imaging is not reliable enough to confidently diagnose OP and such reports should be viewed with some caution and reservation (PMID 27565934, 28481788) (BOOP sine pathology. Organizing pneumonia is a clinical and a pathologic syndrome that may develop idiopathically or in association with an infection or hematologic, CTD or bowel disease unexposed to therapy drugs (PMID 16704928). Regardless of etiology, OP manifests with cough, fever, dyspnea and areas of parenchymal consolidation which may fluctuate or wander on serial imaging, multiple nodules, a mass or masses. Short of withdrawing the causal drug, serial relpases may occur even with continued corticosteroid therapy. Mild OP cases may not require steroid therapy. Suggestive OP features: 1) Migratory pulmonary opacities on sequential imaging, 2) Confirmatory pathology (not required in every case), 3) Lack of prominent BAL or tissue eosinophilia 4) Exposure to a compatible drug 5) Abatement of all signs and symptoms following drug discontinuance without corticosteroid therapy 6) Absence of relapse over at least one year follow-up. OP cases diagnosed on imaging only are considered low evidence (e.g. PMID 21761513). Only pathologically OP cases are included here and under OP in XV 'Pathology' . See also under 'Relapsing pneumonitis'.
Publications
Organizing pneumonia secondary to amiodarone treatment.
Heliyon 2022 Sep;8;e10630 — 2022 Sep — e10630
Drakopanagiotakis F, Paschalaki K, Abu-Hijleh M, Aswad B, Karagianidis N, Kastanakis E, Braman SS, Polychronopoulos V
Cryptogenic and secondary organizing pneumonia: clinical presentation, radiographic findings, treatment response, and prognosis.
Chest 2011 Apr;139;893-900 — 2011 Apr — 893-900
[Bronchiolitis obliterans with organized pneumonia secondary to amiodarone: presentation of two cases with different therapeutic approach].
Revista clinica espanola 2009 Dec;209;568-9 — 2009 Dec — 568-9
Organizing pneumonia: typical and atypical HRCT patterns.
La Radiologia medica 2006 Mar;111;202-12 — 2006 Mar — 202-12
Bronchiolitis obliterans organizing pneumonia. Clinical and roentgenological features in 26 cases.
Respiration; international review of thoracic diseases 2005 May-Jun;72;254-62 — 2005 May-Jun — 254-62
Acute fibrinous and organizing pneumonia: a histological pattern of lung injury and possible variant of diffuse alveolar damage.
Archives of pathology & laboratory medicine 2002 Sep;126;1064-70 — 2002 Sep — 1064-70
Bronchiolitis obliterans organising pneumonia secondary to amiodarone treatment.
The Netherlands journal of medicine 1998 Sep;53;109-12 — 1998 Sep — 109-12
Bronchiolitis obliterans organizing pneumonia secondary to amiodarone: clinical, radiological and histological pattern.
Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace 1997 Feb;52;24-6 — 1997 Feb — 24-6
Bronchiolitis obliterans organizing pneumonia during low-dose amiodarone therapy.
Clinical cardiology 1997 Mar;20;300-2 — 1997 Mar — 300-2
Bronchiolitis obliterans organizing pneumonia secondary to amiodarone: a rare aetiology.
The European respiratory journal 1995 Mar;8;470-1 — 1995 Mar — 470-1
Amiodarone pneumonitis: three further cases with a review of published reports.
Thorax 1984 Jan;39;57-64 — 1984 Jan — 57-64
Bronchiolitis obliterans organising pneumonia in patients taking acebutolol or amiodarone.
Thorax 1989 Sep;44;711-5 — 1989 Sep — 711-5