Cryptogenic organizing pneumonia. Characteristics of relapses in a series of 48 patients. The Groupe d'Etudes et de Recherche sur les Maladles "Orphelines" Pulmonaires (GERM"O"P)
Details
Serval ID
serval:BIB_7B3EB780AA58
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cryptogenic organizing pneumonia. Characteristics of relapses in a series of 48 patients. The Groupe d'Etudes et de Recherche sur les Maladles "Orphelines" Pulmonaires (GERM"O"P)
Journal
American Journal of Respiratory and Critical Care Medicine
ISSN
1073-449X
Publication state
Published
Issued date
08/2000
Peer-reviewed
Oui
Volume
162
Number
2 Pt 1
Pages
571-7
Notes
Journal Article
Research Support, Non-U.S. Gov't
Research Support, Non-U.S. Gov't
Abstract
Cryptogenic organizing pneumonia (COP) is a clinicopathologic syndrome characterized by rapid resolution with corticosteroids, but frequent relapses when treatment is tapered or stopped. We retrospectively studied relapses in 48 cases of biopsy-proven COP. One or more relapses (mean 2.4 +/- 2.2) occurred in 58%. At first relapse, 68% of patients were still under treatment for the initial episode. Compared with the no-relapse group, nine patients with multiple (>/= 3) relapses had longer delays between first symptoms and treatment onset (22 +/- 17 versus 11 +/- 8 wk, p = 0.02), and elevated gamma-glutamyltransferase (124 +/- 98 versus 29 +/- 13 IU/L, p = 0.001) and alkaline phosphatase (190 +/- 124 versus 110 +/- 68 IU/L, p = 0.04) levels. Relapses did not adversely affect outcome. Corticosteroid treatment side effects occurred in 25% of patients. Standardized treatment in 14 patients allowed a reduction of prednisone cumulated doses (p < 0.05) without affecting outcome or relapse rate. We conclude that: (1) delayed treatment increases the risk of relapses; (2) mild cholestasis identifies a subgroup of patients with multiple relapses; (3) relapses do not affect outcome, and prolonged therapy to suppress relapses appears unnecessary; (4) a standardized treatment allows a reduction in steroid doses.
Keywords
Adult
Aged
Alkaline Phosphatase/blood
Bronchiolitis Obliterans Organizing Pneumonia/drug
therapy/mortality/*physiopathology
Cholestasis/complications
Female
Humans
Male
Middle Aged
Prednisone/adverse effects/therapeutic use
Probability
Recurrence
Retrospective Studies
Treatment Outcome
gamma-Glutamyltransferase/blood
Pubmed
Web of science
Create date
19/12/2008 12:59
Last modification date
20/08/2019 15:37