A case of bronchiolitis obliterans organizing pneumonia associated with wheezing.

Abstract

BOOP is a clinopathologic entity consisting of a flu-like illness, late inspiratory crackles, and pathologically granulation tissue plugs within lumens of small airways sometimes with complete obstruction of small airways and granulation tissue extending into alveolar ducts and alveoli with a variable degree of interstitial infiltration of mononuclear cells and accumulation of foamy macrophages in alveolar spaces in a patch distribution, and preservation of background architecture of the lung. It has patch infiltrates roentgenographically, and restrictive ventilatory defect pysiologically such as decreased vital capacity. and diffusing capacity. The BOOP has been observed in the context of collagen vascular disease, and other autoimmune disease secondary to treatment with penicillamine, bleomycin, acebutolol and amiodarone, following the inhalation of toxic fumes, after several infections including measles, pertussis and influenza and idiopathic. Clinically, response to coricosteroid therapy is good and relapse dose not occur if sufficient theraphy is good. A flu-like illness occurs in one third, cough in one third, cough with dyspnea in the remaining patients. Hemoptysis are rare. The physical examination reveales dry crackles in the majority of the patients with BOOP but rarely associated with wheezing. The duration of illness is less than 2 months in 75% of patients. With a brief review of literature, we report a case of the BOOP which is good response to steroid, but frequent relapse and assoicated with wheezing.