Publications
Bronchiolitis obliterans organizing pneumonia as the pulmonary manifestation of lupus: A review of three cases
Ritasman Baisya Phani Kumar Devarasetti Shantveer G Uppin Ramakrishna Narayanan Liza Rajasekhar K S Sreejitha Abstract
Objective: Bronchiolitis obliterans organizing pneumonia (BOOP) is a clinico-patho-radiological diagnosis which rarely presents as a pulmonary manifestation of lupus. In this concise report, organizing pneumonia was found as the sole pulmonary manifestation of SLE in different age groups.
Method: All three patients diagnosed with SLE according to SLICC 2012 classification criteria, were admitted in rheumatology ward of NIMS hospital, Hyderabad, India from May to November, 2018. Their diagnosis of BOOP was either biopsy proven or imaging guided. Review of literature was done with MeSH terms (SLE, BOOP) in PubMed and approximately 10 articles were reviewed including latest of 2019 published in Scientific Reports.
Result: There were three patients - one juvenile lupus and two adults. Two patients were male and one female. All three patients had SLE with high disease activity. They all had organising pneumonia as pulmonary manifestation with other organ involvement. Juvenile patient had a fatal outcome while the others had a good recovery with steroid and immunosuppressive.
Conclusion: BOOP is a rare pulmonary manifestation in lupus. It can be diagnosed early with more precision using computerised tomography of lung without waiting for biopsy report. This will result in a better prognosis by rapid initiation of corticosteroid and immunosuppressive treatment.
Keywords: Bronchiolitis obliterans organizing pneumonia; glucocorticoid; high resolution computer tomography; systemic lupus erythematosus; transbronchial lung biopsy.
