The presence of connective tissue diseases, antinuclear antibodies, antithyroid antibodies, antineutrophil cytoplasmic antibodies, rheumatoid factor, and serological tests for Mycoplasma pneumoniae, Chlamydia pneumoniae, and Legionella pneumophila were assessed. Routine blood and urine tests, microbiological sputum and/or bronchial washing examinations, immunological and cytological assessments of bronchoalveolar lavage (BAL) specimens, ultrasound examinations of the abdomen and thyroid gland, and pulmonary function tests were conducted. All patients were evaluated regarding their medical history, smoking, additional diseases, consumption of medicines, symptoms, and symptom duration. All volunteered to take CAM in preference to PRE and gave written informed consent. All patients given CAM were informed that steroids were the standard treatment for OP and that the effectiveness of CAM was not sufficiently proven. appeared, we reduced the starting dose to 0.5 mg/kg/d and the course to (usually) 6 months. We earlier presented data on 43 patients.Īll patients were initially treated with prednisone beginning at 1 mg/kg/d with subsequent dose reduction, for 12 (rarely 18) months. A diagnosis of COP was established in 57 patients in 5 patients, OP was secondary to breast cancer radiotherapy. The observation period ended in June 2016. ![]() However, we here (retrospectively) analyze only 62 patients who were respiratory sufficient. The aim of this study was to compare the results of CAM versus prednisone (PRE) in patients with OP.įrom 1999 to 2014, 76 patients with OP were diagnosed in our Department. Previous data showed potential activities of macrolides in patients with COP. ![]() These cytokines are essential chemotactic factors for neutrophils and play important roles in the pathogenesis of COP. Concentrations of inflammatory mediators, such as tumor necrosis factor (TNF), interleukin 8 (IL-8), and interleukin 1b (IL-1b), produced by the endothelium and respiratory tract cells are diminished during treatment with these antibiotics. Macrolides have specific activity against many Gram-positive and Gram-negative bacteria they also demonstrate nonspecific anti-inflammatory effects. Other immunosuppressive therapies, such as cyclophosphamide, cyclosporine, and macrolides, also seem to be effective. Regression is observed quickly after treatment initiation however, the tapering of steroids can induce relapse in about 50% of cases. Corticosteroids are the standard treatment for OP. The prognosis of the disease is usually good, and spontaneous regression of COP occurs in about 5% to 10% of cases. Histologically, OP is defined by an organized inflammatory exudate in alveoli and small bronchioli in the shape of characteristic polyps and variable degrees of interstitial inflammation the lung parenchyma is preserved. Clinical features include subacute flu-like disease onset with cough, slight fever, weakness, progressive exertional dyspnea, sweats, weight loss, and migratory opacities (often bilateral) on chest X-rays. Causes of the secondary form are mainly infections, exposure to toxic substances, drugs, connective tissue diseases, malignancies, autoimmune diseases, bone marrow or organ transplantation, and radiotherapy. ![]() It is classified as cryptogenic OP (COP) when the triggering factor is unknown or secondary. Organizing pneumonia (OP) is a distinct clinicopathological entity that results from the pulmonary reaction to various injuries. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: This study was supported by National Tuberculosis and Lung Diseases Research Institute grant Nr 7.3.Ĭompeting interests: The authors have declared that no competing interests exist. Received: JanuAccepted: AugPublished: September 25, 2017Ĭopyright: © 2017 Radzikowska et al. PLoS ONE 12(9):Įditor: Antje Prasse, Medizinische Hochschule Hannover, GERMANY (2017) Cryptogenic organizing pneumonia-Results of treatment with clarithromycin versus corticosteroids-Observational study. ![]() Citation: Radzikowska E, Wiatr E, Langfort R, Bestry I, Skoczylas A, Szczepulska-Wójcik E, et al.
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