Radzikowska Elzbieta, Wiatr Elzbieta, Gawryluk Dariusz, Langfort Renata, Bestry Iwona, Chabowski Mariusz, Roszkowski Kazimierz
III Klinika Chorób Płuc Instytutu Gruźlicy i Chorób Płuc w Warszawie Kierownik.
Pneumonol Alergol Pol. 2008;76(5):334-9.
Organizing pneumonia (OP) is a rare syndrome that has been associated with a variety of underlying factors including infections, collagen vascular diseases, toxic fumes, cancer, drugs and radiotherapy. A cryptogenic form is also observed. OP is a curable disease in the most cases. Steroids are the standard therapy, but other treatment regimens have been used as well.
In the period from 1999 to 2005, 9 women and 3 men (age range 44-71 years) with OP were selected for the study. There were 9 non-smokers, 2 smokers and 1 ex-smoker. Open lung biopsy was performed in 5 patients, and in 7 patients diagnosis was established on the basis of transbronchial lung biopsy.
Dyspnoea (100%), cough (100%), weakness (100%), fever (83%), loss of weight (83%), sweats (33%) and chest pain (8%) were the most frequently noticed symptoms. Radiographically, all patients had bilateral consolidations with areas of ground glass attenuations. A migratory pattern of these lesions was observed in 9 (75%) patients. In all patients clarithromycin (CLA) in a dose 0.5 g b.i.d was administered. Nine (75%) patients were successfully treated. Complete clinical and radiological remission was obtained after 3 months of CLA therapy in 7 and a partial response in an additional 2 patients, in whom treatment was prolonged to 4 months. During the first month of CLA treatment 3 patients did not respond to the therapy, and prednisone was introduced. The observation period ranged from 30 to 90 months (mean 42 months). Adverse reaction to CLA and relapse did not occur.
OP can be treated with clarithromycin. It may be an alternative treatment, particularly for patients in good clinical status and in whom the probability of adverse events in the course of corticotherapy is high.
机化性肺炎（OP）是一种罕见的综合征，与多种潜在因素相关，包括感染、胶原血管疾病、有毒烟雾、癌症、药物和放疗。也观察到一种隐源性形式。在大多数情况下，OP是一种可治愈的疾病。类固醇是标准治疗方法，但也使用了其他治疗方案。
在1999年至2005年期间，选择了9名女性和3名男性（年龄范围44 - 71岁）患有OP的患者进行研究。有9名非吸烟者，2名吸烟者和1名既往吸烟者。5例患者进行了开胸肺活检，7例患者根据经支气管肺活检确诊。
呼吸困难（100%）、咳嗽（100%）、乏力（100%）、发热（83%）、体重减轻（83%）、盗汗（33%）和胸痛（8%）是最常出现的症状。影像学上，所有患者均有双侧实变并伴有磨玻璃样密度减低区。9例（75%）患者观察到这些病变的游走模式。所有患者均给予剂量为0.5 g bid的克拉霉素（CLA）。9例（75%）患者成功治愈。CLA治疗3个月后，7例患者获得完全临床和影像学缓解，另外2例患者部分缓解，治疗延长至4个月。在CLA治疗的第一个月，3例患者对治疗无反应，遂加用泼尼松。观察期为30至90个月（平均42个月）。未发生CLA不良反应和复发。
OP可用克拉霉素治疗。它可能是一种替代治疗方法，特别是对于临床状态良好且皮质激素治疗过程中发生不良事件可能性高的患者。
