Organizing pneumonia revisited: insights and uncertainties from a series of 67 patients

Organizing pneumonia revisited: insights and uncertainties from a series of 67 patients

Authors

  • A. L. Vieira Pulmonology Department, Hospital de Braga, Portugal
  • A. Vale Pulmonology Department, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal
  • P. Caetano Mota Pulmonology Department and Diffuse Lung Diseases Study Group, Centro Hospitalar de São João, Porto, Portugal
  • J. M. Jesus Radiology Department, Centro Hospitalar de São João, Porto, Portugal
  • R. Cunha Radiology Department, Centro Hospitalar de São João, Porto, Portugal
  • S. Guimarães Pathology Department, Centro Hospitalar de São João, Porto, Portugal
  • C. Souto Moura Pathology Department, Centro Hospitalar de São João, Porto, Portugal
  • A. Morais Pulmonology Department and Diffuse Lung Diseases Study Group, Centro Hospitalar de São João, Porto, Portugal

Abstract

Background: Organizing pneumonia (OP) is classified as an acute/subacute pneumonia according to the American Thoracic Society/European Respiratory Society statement (2013 update). Although its clinical presentation, radiologic and histologic features are well established, data on the relevance of potential causes, corticosteroid doses and length, or management of relapses are based on heterogeneous series of patients. Objectives: The aims of this study were to describe clinical presentation, diagnosis and treatment of OP, explore potential causes, discuss strategies for managing relapses, and analyze prognostic factors. We also discuss our findings in relation to relevant data in the literature. Methods: We performed a cross-sectional study of all patients diagnosed with OP at a tertiary referral center in northern Portugal between 2008 and 2015. Results: Sixty-seven patients were diagnosed with OP over the 7-year study period. Dyspnea and cough were the most common presenting symptoms and approximately 30% of patients were hospitalized at the time of diagnosis. Approximately half of the patients were receiving drugs described as potential causes of OP. Microorganisms were isolated in approximately one-third of patients. Other potential causes identified were hematologic disorders, neoplasms, connective tissue diseases, myelodysplastic syndromes, immunodeficiencies, radiotherapy, and bird exposure. Cryptogenic OP was diagnosed in just 16 patients (23.8%). Corticosteroids were the most common treatment and 11 patients (16.4%) experienced relapse. Conclusions: The findings for this series of patients confirm the extreme variability of the contexts in which OP can occur and suggest that rather than a distinct, homogeneous clinicopathologic entity, OP is a non-specific reaction whose outcomes are dependent on the cause.

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Published

01-07-2018

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Section

Original Articles: Clinical Research

How to Cite

1.
Vieira AL, Vale A, Caetano Mota P, Jesus JM, Cunha R, Guimarães S, et al. Organizing pneumonia revisited: insights and uncertainties from a series of 67 patients. Sarcoidosis Vasc Diffuse Lung Dis [Internet]. 2018 Jul. 1 [cited 2025 Apr. 2];35(2):129-38. Available from: https://mattioli1885journals.com/index.php/sarcoidosis/article/view/6860