Cryptogenic Organizing Pneumonia

Basics

Basics

Basics

Description

Description

Description

  • Cryptogenic organizing pneumonia or COP is the idiopathic inflammatory process of diffuse interstitial granulation extending to the distal airways and alveoli.
  • As opposed to secondary organizing pneumonia that has multiple causative etiologies such as medication, infection, connective tissue disease, malignancy, and so forth, COP has no known precipitant.
  • May have a gradual or sudden onset
  • Unknown pathogenesis
  • Chest x-ray (CXR) typically shows a pattern of bilateral, diffuse, or patchy infiltrates and consolidative or ground-glass opacifications. There may be air bronchograms as well.
  • Completely reversible restrictive problem. Most cases will respond to corticosteroids, which may have to be given for a year or more.
  • Synonym(s): previously known as bronchiolitis obliterans with organizing pneumonia or BOOP; intraluminal fibrosis of distal airways; idiopathic BOOP; obliterative bronchiolitis

Geriatric Considerations
More common than originally thought and may be sudden and very severe in geriatric patients
Pediatric Considerations
Rare but has been reported after viral pneumonia

Epidemiology

Epidemiology

Epidemiology

  • Incidence/prevalence in the United States: estimated at 0.01% but may be underdiagnosed
  • Predominant age: most commonly seen in age 50s to 60s
  • Males and females affected equally

Prevalence
Unknown

Etiology and Pathophysiology

Etiology and Pathophysiology

Etiology and Pathophysiology

Idiopathic: a specific complex reaction of lung tissue leading to alveolar wall injury
Genetics
No known genetic component

Risk Factors

Risk Factors

Risk Factors

  • Immunocompromised patients, including transplant recipients and AIDS patients
  • Other autoimmune conditions
  • Gastroesophageal reflux disease causing microaspiration
  • Reported frequency of tobacco use in diagnosed cases 25–50%, making smoking unlikely to be a precipitating factor

General Prevention

General Prevention

General Prevention

Except for prevention of relapse, none known

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