Factors associated with the relapse of cryptogenic and secondary organizing pneumonia

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• 作者：Yasutaka Onishi ; MD ; ^{yonishi@hmj-net.hosp.go.jp} ; Tetsuji Kawamura ; MD ^{kawa-t@hmj-net.hosp.go.jp} ; Yasuharu Nakahara ; MD ^{nakahary@hmj-net.hosp.go.jp} ; Ryogo Kagami ; MD ^{ryogo@hmj-net.hosp.go.jp} ; Shin Sasaki ; MD ^{sasakis@hmj-net.hosp.go.jp} ; Sayaka Takahashi ; MD ^{syk19860203@gmail.com} ; Ryota Kominami ; MD ^{k8181@hmj-net.hosp.go.jp} ; Katsuya Hirano ; MD ^{katsu614@hmj-net.hosp.go.jp} ; Ryota Hiraoka ; MD ^{rhiraoka@hmj-net.hosp.go.jp} ; Nobuya Hirata ; MD ^{nhirata@hmj-net.hosp.go.jp}
• 关键词：OP ; Organizing pneumonia ; BAL ; bronchoalveolar lavage ; COP ; Cryptogenic OP ; SOP ; secondary OP ; SpO2 ; oxyhemoglobin saturation measured by pulse oximetry ; WBC ; white blood cells ; LDH ; lactate dehydrogenase ; CRP ; C reactive protein ; KL-6 ; Krebs von den Lungen-6 ; SP-D ; surfactant protein D ; RF ; rheumatoid factor ; ANA ; antinuclear antibody ; CT ; computed tomography ; HRCT ; high-resolution computed tomography ; GGO ; ground-glass opacity ; BALF ; BAL fluid ; OR ; odds ratio ; CI ; confidence interval ; NCA ; neu
• 刊名：Respiratory Investigation
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：55
• 期：1
• 页码：10-15
• 全文大小：934 K
• 卷排序：55

文摘

Organizing pneumonia (OP) is a histopathological response pattern to lung inflammation. It is clinically classified into cryptogenic OP and secondary OP, which is associated with various clinical conditions. Rapid resolution with corticosteroids and frequent relapses are common in OP. However, few studies have investigated the factors associated with OP relapse.MethodsThe medical records of 75 patients with biopsy-proven OP, diagnosed between January 2010 and August 2015, who underwent corticosteroid therapy were retrospectively reviewed. Initially, the patients were all treated successfully; however, 31 patients experienced relapse thereafter (R group), whereas the others did not (NR group; 44 patients). The clinical, radiological, and pathological characteristics and administered corticosteroid doses were compared between the two groups.ResultsThe neutrophil percentage in the bronchoalveolar lavage (BAL) fluid and the level of fibrin deposition in lung biopsy specimens were higher in the R group than in the NR group (P=0.01 and P=0.002, respectively). The multivariate analysis demonstrated that both factors were statistically significant predictors of OP relapse.ConclusionsA high neutrophil percentage in the BAL and the level of fibrin deposition in lung biopsy specimens are considered predictive factors of OP relapse during the tapering or after the cessation of steroid therapy. Patients without these findings may be treated with low-dose corticosteroids.