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Current approaches in the diagnosis and treatment of organizing pneumonia

Year 2025, Volume: 7 Issue: 1, 89 - 93, 10.01.2025
https://doi.org/10.38053/acmj.1599119

Abstract

Organizing pneumonia (OP), is a rare yet well-defined form of interstitial lung disease. The condition can be idiopathic, termed cryptogenic organizing pneumonia (COP), or secondary to various causes, including infections, connective tissue diseases, medications, and malignancies. OP typically presents with nonspecific symptoms such as cough, dyspnea, fever, and weight loss, often mimicking other respiratory conditions like pneumonia or interstitial lung diseases. Radiological findings are varied but commonly include bilateral, patchy consolidations or ground-glass opacities with preserved lung volumes. Diagnosis often requires high-resolution computed tomography (HRCT) and may be confirmed by lung biopsy when clinical and imaging findings are inconclusive. Laboratory studies and bronchoalveolar lavage can aid in excluding alternative diagnoses. Glucocorticoids remain the mainstay of treatment, with most patients responding well to therapy. This review explores current advances in the diagnosis, differential diagnosis, and management of OP, emphasizing the importance of a multidisciplinary approach to optimize patient outcomes.

References

  • King TE Jr, Lee JS. Cryptogenic organizing pneumonia. N Engl J Med. 2022;386(11):1058-1069.
  • Choi KH, Lee HB, Jeong MY, et al. The role of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in cryptogenic organizing pneumonia. Chest. 2002;121(5):1478-1485.
  • Lappi-Blanco E, Soini Y, Kinnula V, et al. VEGF and bFGF are highly expressed in intraluminal fibromyxoid lesions in bronchiolitis obliterans organizing pneumonia. J Pathol. 2002;196(2):220-227.
  • Gaillet G, Favelle O, Guilleminault L, et al. Gastroesophageal reflux disease is a risk factor for severity of organizing pneumonia. Respiration. 2015;89(2):119-126.
  • Zhang Y, Li N, Li Q, et al. Analysis of the clinical characteristics of 176 patients with pathologically confirmed cryptogenic organizing pneumonia. Ann Transl Med. 2020;8(12):763.
  • Ozdemirel TS, Bulut S, Akkurt ES, et al. Does cryptogenic organizing pneumonia change seasonal? Rev Assoc Med Bras (1992). 2023;69(2):267-271.
  • Izumi T, Kitaichi M, Nishimura K, Nagai S. Bronchiolitis obliterans organizing pneumonia. Clinical features and differential diagnosis. Chest. 1992;102(3):715-719.
  • Bartter T, Irwin RS, Nash G, et al. Idiopathic bronchiolitis obliterans organizing pneumonia with peripheral infiltrates on chest roentgenogram. Arch Intern Med. 1989;149(2):273-279.
  • Cordier JF. Organising pneumonia. Thorax. 2000; 55(4):318-328.
  • Cordier JF. Cryptogenic organising pneumonia. Eur Respir J. 2006;28(2): 422-446.
  • Bradley B, Branley HM, Egan JJ, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008; 63(Suppl 5):v1-58.
  • Niksarlıoğlu EY, Özkan GZ, Bakan ND, Yurt S, Kılıç L, Çamsarı G. Cryptogenic organizing pneumonia: clinical and radiological features, treatment outcomes of 17 patients, and review of the literature. Turk J Med Sci. 2016;46(6):1712-1718.
  • Stover DE, Mangino D. Macrolides: a treatment alternative for bronchiolitis obliterans organizing pneumonia? Chest. 2005;128(5):3611-3617.
  • Vaz AP, Morais A, Melo N, et al. Azithromycin as an adjuvant therapy in cryptogenic organizing pneumonia. Rev Port Pneumol. 2011;17(4):186-189.
  • Lazor R, Vandevenne A, Pelletier A, et al. Cryptogenic organizing pneumonia. Characteristics of relapses in a series of 48 patients. The Groupe d'Etudes et de Recherche sur les Maladles "Orphelines" Pulmonaires (GERM"O"P). Am J Respir Crit Care Med. 2000;162(2 Pt 1): 571-577.
  • Kim M, Cha SI, Seo H, et al. Predictors of relapse in patients with organizing pneumonia. Tuberc Respir Dis (Seoul). 2015;78(3):190-195.
  • Saito Z, Kaneko Y, Hasegawa T, et al. Predictive factors for relapse of cryptogenic organizing pneumonia. BMC Pulm Med. 2019;9;19(1):10.

Organize pnömoni tanısı ve tedavisinde güncel yaklaşımlar

Year 2025, Volume: 7 Issue: 1, 89 - 93, 10.01.2025
https://doi.org/10.38053/acmj.1599119

Abstract

Organize pnömoni (OP), nadir görülen ancak iyi tanımlanmış bir interstisyel akciğer hastalığı türüdür. Durum, kriptojenik organize pnömoni (COP) olarak adlandırılan idiyopatik veya enfeksiyonlar, bağ dokusu hastalıkları, ilaçlar ve maligniteler dahil olmak üzere çeşitli nedenlere bağlı olabilir. OP tipik olarak öksürük, dispne, ateş ve kilo kaybı gibi spesifik olmayan semptomlarla ortaya çıkar ve sıklıkla pnömoni veya interstisyel akciğer hastalıkları gibi diğer solunum yolu rahatsızlıklarını taklit eder. Radyolojik bulgular çeşitlidir ancak genellikle bilateral, yamalı konsolidasyonlar veya korunmuş akciğer hacimleriyle buzlu cam opasiteleri içerir. Tanı genellikle yüksek çözünürlüklü bilgisayarlı tomografi (HRCT) gerektirir ve klinik ve görüntüleme bulguları kesin olmadığında akciğer biyopsisi ile doğrulanabilir. Laboratuvar çalışmaları ve bronkoalveolar lavaj alternatif tanıları dışlamaya yardımcı olabilir. Glukokortikoidler tedavinin temelini oluşturmaya devam etmektedir ve çoğu hasta tedaviye iyi yanıt vermektedir.
Bu derlemede OP tanısı, ayırıcı tanısı ve tedavisindeki güncel gelişmeler incelenmekte ve hasta sonuçlarını iyileştirmek için multidisipliner yaklaşımın önemi vurgulanmaktadır.

References

  • King TE Jr, Lee JS. Cryptogenic organizing pneumonia. N Engl J Med. 2022;386(11):1058-1069.
  • Choi KH, Lee HB, Jeong MY, et al. The role of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 in cryptogenic organizing pneumonia. Chest. 2002;121(5):1478-1485.
  • Lappi-Blanco E, Soini Y, Kinnula V, et al. VEGF and bFGF are highly expressed in intraluminal fibromyxoid lesions in bronchiolitis obliterans organizing pneumonia. J Pathol. 2002;196(2):220-227.
  • Gaillet G, Favelle O, Guilleminault L, et al. Gastroesophageal reflux disease is a risk factor for severity of organizing pneumonia. Respiration. 2015;89(2):119-126.
  • Zhang Y, Li N, Li Q, et al. Analysis of the clinical characteristics of 176 patients with pathologically confirmed cryptogenic organizing pneumonia. Ann Transl Med. 2020;8(12):763.
  • Ozdemirel TS, Bulut S, Akkurt ES, et al. Does cryptogenic organizing pneumonia change seasonal? Rev Assoc Med Bras (1992). 2023;69(2):267-271.
  • Izumi T, Kitaichi M, Nishimura K, Nagai S. Bronchiolitis obliterans organizing pneumonia. Clinical features and differential diagnosis. Chest. 1992;102(3):715-719.
  • Bartter T, Irwin RS, Nash G, et al. Idiopathic bronchiolitis obliterans organizing pneumonia with peripheral infiltrates on chest roentgenogram. Arch Intern Med. 1989;149(2):273-279.
  • Cordier JF. Organising pneumonia. Thorax. 2000; 55(4):318-328.
  • Cordier JF. Cryptogenic organising pneumonia. Eur Respir J. 2006;28(2): 422-446.
  • Bradley B, Branley HM, Egan JJ, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008; 63(Suppl 5):v1-58.
  • Niksarlıoğlu EY, Özkan GZ, Bakan ND, Yurt S, Kılıç L, Çamsarı G. Cryptogenic organizing pneumonia: clinical and radiological features, treatment outcomes of 17 patients, and review of the literature. Turk J Med Sci. 2016;46(6):1712-1718.
  • Stover DE, Mangino D. Macrolides: a treatment alternative for bronchiolitis obliterans organizing pneumonia? Chest. 2005;128(5):3611-3617.
  • Vaz AP, Morais A, Melo N, et al. Azithromycin as an adjuvant therapy in cryptogenic organizing pneumonia. Rev Port Pneumol. 2011;17(4):186-189.
  • Lazor R, Vandevenne A, Pelletier A, et al. Cryptogenic organizing pneumonia. Characteristics of relapses in a series of 48 patients. The Groupe d'Etudes et de Recherche sur les Maladles "Orphelines" Pulmonaires (GERM"O"P). Am J Respir Crit Care Med. 2000;162(2 Pt 1): 571-577.
  • Kim M, Cha SI, Seo H, et al. Predictors of relapse in patients with organizing pneumonia. Tuberc Respir Dis (Seoul). 2015;78(3):190-195.
  • Saito Z, Kaneko Y, Hasegawa T, et al. Predictive factors for relapse of cryptogenic organizing pneumonia. BMC Pulm Med. 2019;9;19(1):10.
There are 17 citations in total.

Details

Primary Language English
Subjects Chest Diseases
Journal Section Review
Authors

Maşide Arı 0000-0002-5078-3176

Publication Date January 10, 2025
Submission Date December 10, 2024
Acceptance Date December 31, 2024
Published in Issue Year 2025 Volume: 7 Issue: 1

Cite

AMA Arı M. Current approaches in the diagnosis and treatment of organizing pneumonia. Anatolian Curr Med J / ACMJ / acmj. January 2025;7(1):89-93. doi:10.38053/acmj.1599119

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