Cryptogenic organizing pneumonia - wrongfully neglected disease

Abstract

Introduction. Cryptogenic organizing pneumonia (COP) is a type of organizing pneumonia with an unknown primary etiology. Diagnosis of COP requires exclusion of any other possible cause. The disease manifests with nonspecific symptoms and clinical findings resembling respiratory infection. Diagnosis of COP should be considered after the radiographic signs of pneumonia persist despite applied therapy, or show a migratory pattern. Due to a diverse differential diagnostic palette, establishing the correct diagnosis is often delayed, resulting in delayed administration of adequate therapy. Outlines of cases. In this paper, we present three female patients diagnosed with COP in our clinic. We outline all challenges in the diagnostic pathways, from managing initial symptoms, through all necessary laboratory tests and diagnostic procedures, to establishing the diagnosis and starting treatment. After presenting radiological findings before and after starting corticosteroid treatment, we also reevaluated the clinical response to the administered treatment initially and during the subsequent follow-up period. Conclusion. To diagnose COP, we must first remind ourselves to consider it when treating patients with recurrent pneumonia. When COP is finally diagnosed, the quality of life of these patients improves, as this avoids excessive antimicrobial therapy and repeated hospitalizations. A multidisciplinary approach is needed, both in diagnosing and treating patients, owing to comorbidities and the need to exclude any other potential cause of organizing pneumonia. Corticosteroid treatment provides rapid resolution of symptoms followed by long remission periods.

Keywords

• cryptogenic organizing pneumonia
• diagnosis
• differential diagnosis