Lazor Romain
Service de Pneumologie, BHH C, Inselspital - Hôpital Universitaire de Berne, CH-3010 Berne, Suisse.
Rev Pneumol Clin. 2005 Jun;61(3):193-202. doi: 10.1016/s0761-8417(05)84812-6.
Organising Pneumonia (formerly called Bronchiolitis Obliterans with Organising Pneumonia) is a particular form of inflammatory and fibroproliferative lung disease. Its idiopathic form called Cryptogenic Organising Pneumonia, was recently defined by an ATS/ERS consensus conference. The disease onset is subacute with cough, dyspnea, fever, asthenia, weight loss, crackles, and elevation of biological inflammatory markers. Bronchoalveolar lavage reveals a mixed alveolitis with elevated lymphocyte, neutrophil, and eosinophil counts. Chest imaging usually shows multifocal alveolar opacities predominating in the subpleural regions, often with a migratory pattern. Lung biopsy reveals budding connective tissue filling the distal airspaces. Diagnosis is established by combining clinical, radiological and histological criteria. Similarities with other disease processes can lead to delayed or erroneous diagnosis. Most patients respond well to corticosteroid therapy. Relapses are frequent but can generally be controlled with moderate doses of prednisone and do not worsen the prognosis. The therapeutic strategy aims at reducing the steroid doses while maintaining an optimal disease control.
机化性肺炎（以前称为闭塞性细支气管炎伴机化性肺炎）是一种特殊形式的炎症性和纤维增生性肺病。其特发性形式称为隐源性机化性肺炎，最近由美国胸科学会/欧洲呼吸学会共识会议定义。该病起病亚急性，表现为咳嗽、呼吸困难、发热、乏力、体重减轻、啰音以及生物学炎症标志物升高。支气管肺泡灌洗显示混合性肺泡炎，淋巴细胞、中性粒细胞和嗜酸性粒细胞计数升高。胸部影像学通常显示多灶性肺泡实变，以胸膜下区域为主，常呈游走性。肺活检显示芽生结缔组织填充远端气腔。通过结合临床、放射学和组织学标准进行诊断。与其他疾病过程的相似性可能导致诊断延迟或错误。大多数患者对皮质类固醇治疗反应良好。复发很常见，但一般可以用中等剂量的泼尼松控制，且不会使预后恶化。治疗策略旨在减少类固醇剂量，同时维持对疾病的最佳控制。
