The chest X-ray revealed pneumonia in 11 patients, pulmonary congestion in 7 patients, atelectasis in 4 patients, hydrothorax in 5 patients, and BOOP in 1 patient.
Bronchiectasis was found in 8 patients: of whom 2 had no prior lung disease, 2 had bronchiolitis obliterans with organizing pneumonia (BOOP), 3 had asthma and 1 had unknown past-medical history (Table 2).
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Due to these characteristic pathologic findings, biopsy for diagnosis of BOOP is essential [ 4, 5].
For the BOOP, local search (line 6 in Algorithm 1) simply consists in ruining and recreating once the incumbent solution.
Common manifestations of bleomycin-induced lung disease are diffuse alveolar damage, nonspecific interstitial pneumonia (NSIP) and bronchiolitis obliterans organising pneumonia (BOOP) (Fig. 9).
Of the 72 patients with IPF, 21 (29%) had biopsy-proven UIP, 10 patients had bronchiolitis obliterans organizing pneumonia (BOOP), nine had desquamative interstitial pneumonia (DIP), three had lymphocytic interstitial pneumonia (LIP) and in 29 cases (40%) the histology was not specified.
The patient's CD4 T-cell count improved significantly (from 5 to 181 cells/mm) from the time of diagnosis of BOOP until the end of macrolide treatment.
In previous case reports (Allen et al., Liote et al., Laguna Del Estal et al. and Santio et al)., HIV infected patients with BOOP presented with a low CD4 cell count or a low CD4/CD8 ratio, suggesting that severe immune deficiency may be needed for BOOP to develop in this scenario [ 11].
Open image in new window Fig. 4 A 13-year-old girl with suspected organising pneumonia (BOOP) in both lungs.
