Moreau L, Quoix E, Vandevenne A, Dietemann A, Kessler R, Weitzenblum E, Pauli G
Pavillon Laënnec, Hôpital Civil, Strasbourg.
Rev Pneumol Clin. 1998 Jul;54(3):136-43.
We report a series of 19 cases of bronchiolitis obliterans with organized pneumonitis (BOOP) observed in two pneumology units at the Strasbourg University Hospital between July 1987 and June 1997. Mean patient age was 60 years. Clinical features included dry cough, exercise-induced dyspnea, and a flu-like syndrome in three-quarters of the cases. Standard chest x-ray showed a diffuse non-systemized alveolar syndrome with a air bronchogram in 18 cases and an interstitial syndrome in one-third of the cases. computed tomography of the thorax visualized bronchial dilatations by traction of the alveolar syndrome in one-third of the cases. Pulmonary function tests showed moderate restriction. Lymphocytes predominated in bronchio-alveolar lavage fluid. Pathology examination of surgical lung specimens (5 cases), transbronchial biopsies (5 cases) and scan-guided transparietal punctures (4 cases) provided the diagnosis. In 5 cases the diagnosis was based on the radiological and clinical presentation and favorable course on corticosteroid therapy. Recurrence was observed at corticosteroid withdrawal or dose reduction in 7 cases. In this series, bronchiolitis obliterans with organized pneumonitis was probably secondary to rheumatoid arthritis (1 case), breast radiotherapy (3 cases), and drugs (amiodarone: 1 case: sotalol: 2 cases: betaxolol: 1 case). An association with betaxolol has not been previously reported in the literature.
我们报告了1987年7月至1997年6月期间在斯特拉斯堡大学医院的两个肺病科观察到的一系列19例闭塞性细支气管炎伴机化性肺炎（BOOP）病例。患者平均年龄为60岁。临床特征包括干咳、运动性呼吸困难，四分之三的病例有类似流感的综合征。标准胸部X线显示18例为弥漫性非系统性肺泡综合征伴空气支气管征，三分之一的病例为间质性综合征。胸部计算机断层扫描在三分之一的病例中显示肺泡综合征牵拉导致支气管扩张。肺功能测试显示中度受限。支气管肺泡灌洗液中淋巴细胞占主导。手术肺标本病理检查（5例）、经支气管活检（5例）和扫描引导下经胸壁穿刺活检（4例）确诊。5例诊断基于影像学和临床表现以及皮质类固醇治疗效果良好。7例在停用或减少皮质类固醇剂量时复发。在本系列中，闭塞性细支气管炎伴机化性肺炎可能继发于类风湿性关节炎（1例）、乳腺癌放疗（3例）和药物（胺碘酮：1例；索他洛尔：2例；倍他洛尔：1例）。与倍他洛尔的关联此前未见文献报道。
