General Questions about BOOP

When was BOOP discovered?

Dr. Epler first reported BOOP in 1985. During the first part of the century in 1901, Professor Lange of Germany recognized a part of this disease with a description of a respiratory illness in two patients. The lung tissue showed obliteration of the bronchioles. Bronchioles are very small airways. The professor called this bronchiolitis obliterans. From 1901 to 1910, this illness was described after accidental exposure to nitric acid fumes, after someone had measles, and in someone with whooping cough. It even occurred in a small child who had aspirated a prune pit.

Then in the late 1970's, Dr. Epler in Boston was searching a database of thousands of patients with lung disorders. He wanted to unravel the mystery of bronchiolitis obliterans. After years of searching and studying, and with help from his colleagues, an astonishing and extraordinary picture began to appear!

In 1985, he reported 50 patients who had a flu-like illness, "crackles" in the lungs, and lung function tests that showed a decreased lung capacity and a decreased diffusion of oxygen into the blood. The chest x-ray showed a curious surprise -- there were "patchy shadows" in both of the lungs.

Dr. Epler named this illness bronchiolitis obliterans organizing pneumonia (BOOP) because of the pattern seen by the pathologists -- doctors who examine lung tissue material. BOOP has probably been around for centuries, but Dr. Epler described and characterized it as a distinct lung disorder. Some colleagues refer to it as Epler's pneumonia.

What causes BOOP?

Most of the time, the cause of BOOP is not known. It is then referred to as idiopathic BOOP.

Sometimes an infection such as a virus or unusual bacteria will cause BOOP. There has been a report of BOOP caused by the malaria parasite.

There are certain types of medications that will cause BOOP. These include some anti-cancer medications, a heart arrhythmia medication, antibiotics and the illicit use of cocaine.

BOOP is also associated with the rheumatological disorders such as rheumatoid arthritis or lupus erythematosus.

Recently, BOOP has been reported to occur in recipients of bone marrow or lung transplants. It has also occurred after kidney transplantation.

There are miscellaneous causes or associated disorders. Almost every month, there are new reports. For example, BOOP can occur as a result of radiation therapy, lymphoma or other cancers, or exposure to an unusual textile dye processing. Remarkably, a high dose of L-Tryptophan, a popular supplement among health enthusiasts for use in sleep and pain disorders, can cause BOOP. There has even been a report of BOOP from exposure to a high concentration of mold dust.

BOOP can also occur in children as the idiopathic type or associated with bone marrow transplantation.

Who gets BOOP?

Anyone, anywhere in the world, can get BOOP. It occurs in both men and women equally. It usually develops between the ages of 40 years and 60 years. It can occur in children and in patients over 80 years old. BOOP may occur at any time of the year.

How do you get BOOP?

Most of the time, no one knows. Sometimes it can occur after a viral infection or a medication. It is associated with the rheumatological disorders. It also occurs after bone marrow transplantation, lung transplantation and it may occur after kidney transplantation.

There are also unusual miscellaneous causes and associated conditions.

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Diagnosis
Treatment
Types of BOOP
Books and Articles about Boop
Physicians Corner