CLINICAL FEATURES OF BOOP
Occurs in adults of all ages, not related to smoking
Usually a subacute illness: 1/3 present with flu-like illness, 1/3 with cough, 1/3 with cough and dyspnea
On examination: Fine end inspiratory crackles in 2/3. No clubbing.
Laboratory features: increased ESR. Low PaO2 " CXR: 4 patterns evident: (1) bilateral patchy infiltrates- airspace or mixed pattern (2) bilateral linear and nodular opacities (3) focal consolidation (4) multiple large nodules or masses
HRCT: areas of air space consolidation, small nodules or both. Sometimes ground glass opacities.
PFT's: restrictive pattern with low DLCO. No obstruction as you would see in pure bronchiolitis obliterans.
BAL cytology: increased lymphocytes +/- eosinophils
Steroid Response: about 80% have complete resolution within 6 months