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Comparative Study
. 2019 Jan 9;19(1):10.
doi: 10.1186/s12890-018-0764-8.

Predictive factors for relapse of cryptogenic organizing pneumonia

Zenya Saito  1 , Yugo Kaneko  2 , Tsukasa Hasegawa  3 , Masahiro Yoshida  3 , Kyuto Odashima  2 , Tsugumi Horikiri  2 , Akira Kinoshita  2 , Keisuke Saitoh  2 , Kazuyoshi Kuwano  4
Affiliations
Comparative Study

Predictive factors for relapse of cryptogenic organizing pneumonia

Zenya Saito et al. BMC Pulm Med. .

Abstract

Background: Relapse of cryptogenic organizing pneumonia (COP) may lead to poor long-term prognosis and necessitates multiple rounds of steroid treatment with potential adverse effects. The objective of this study is to identify predictive factors of COP relapse by comparing demographic and clinical variables between relapse and non-relapse groups.

Methods: During 2008-2013, 33 COP patients were treated, of which 23 (69.7%) and 10 patients (30.3%) were assigned to the non-relapse and relapse group, respectively. From medical records, we compared the following variables at initial episode: clinical characteristics, serum parameters, chest CT scan findings, and steroid treatment.

Results: Clinical characteristics, cumulative prednisone dose, and steroid treatment duration were similar between groups. In univariate analysis, alternatively, the proportion of patients with bilateral shadow pattern, traction bronchiectasis, and partial remission after steroid treatment was significantly higher in the relapse group. These differences were not significant by multivariate Cox regression analysis.

Conclusions: We identified radiographic findings, such as bilateral shadow pattern, traction bronchiectasis, and partial remission, may have possibility of predictive factors for COP relapse. Larger-scale studies are required to confirm if any are independent predictors of COP relapse.

Keywords: COP; Predictive factor; Radiographic findings; Relapse; Steroid.

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Conflict of interest statement

Ethics approval and consent to participate

The Ethics Committee of the Jikei University Hospital approved the current study (No. 25–330). Informed consent was waived because this was a retrospective study.

Consent for publication

Not applicable.

Competing interests

No potential conflicts of interest exist with any companies/oranizations whose products or services may be discussed in this article.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Typical CT images of non-relapse case. a Ground-glass attenuation with traction bronchiectasis in the right middle lobe and consolidation in the left lower lobe were recognized at the first visit. b Ground-glass attenuation changed into consolidation in the right middle lobe and consolidation apparently expanded in the left lower lobe just before treatment. c All shadows completely vanished after three months and relapse didn’t occur after one year
Fig. 2
Fig. 2
Typical CT images of relapse case. a Consolidation and nodules in the right upper lobe were recognized at the first visit. b These shadows remained without vanishing completely after treatment. c Relapse occurred after six months of treatment
Fig. 3
Fig. 3
Patient selection flow chart. Of the 33 eligible patients diagnosed as COP, 10 patients were classified to relapse group, and 23 patients were non-relapse
See this image and copyright information in PMC

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