Idiopathic bronchiolitis obliterans with organizing pneumonia presenting with adult respiratory distress syndrome

Cryptogenic organising pneumonia

“…Although hypoxaemia with alveolar right-to-left shunt may be well tolerated as mentioned previously, other patients may require mechanical ventilation (noninvasive or with tracheal intubation) or progress to death, especially when corticosteroid treatment is delayed [400,401]. This occurs particularly in patients with delayed diagnosis who may improve once corticosteroid treatment is given (sometimes in association with immunosuppressive agents when corticosteroid resistance is suspected) [248,[402][403][404][405][406][407]. In some patients, underlying conditions or exposure (connective tissue disease, drugs, infection) are associated [248,408].…”

Interstitial lung disease guideline

“…Fulminant OP has since been described in a number of case reports and has a variable but often good outcome, in contrast to AIP. However, when presenting with a clinical picture of the acute respiratory distress syndrome (ARDS),721 fulminant OP may be indistinguishable from AIP, clinically and on HRCT scanning, although traction bronchiectasis, interlobular septal thickening and intralobular reticular abnormalities tend to be more prominent on HRCT in AIP 707…”

Rare diseases bullet 8: Organising pneumonia

“…Cytotoxic drugs, especially cyclophosphamide and azathioprine, are occasionally used to treat COP,90 134 137 139 142but they have not been evaluated. The cytotoxic drugs are usually given in addition to corticosteroids so whether the observed improvement is due to the prolonged course of corticosteroids or to the cytotoxic drug is not known.…”