Treatment of BOOP

Can someone die from BOOP?

Yes, but rarely. Death occurs in less than 5 percent of all patients throughout the world.

Death is more likely in patients with a rapidly progressive illness of a few days, a chest x-ray that shows small linear shadows at the lung bases, and a poor response to corticosteroid (prednisone) medication.

How do you treat BOOP?

Sometimes, no treatment is necessary. BOOP can disappear and resolve without medication. Usually, such patients have minimal symptoms and lung function abnormalities. The chest x-rays can be observed closely until the BOOP disappears.

Most of the time, medication is needed. Since BOOP is inflammation of the lungs, the most appropriate treatment is an anti-inflammation medication. Corticosteroid medication is the current best treatment. This may be given intravenously while in the hospital or given as tablets in the form of prednisone.The starting dose is high often 60 mg per day for several days or a few weeks. It is then decreased to 40 mg per day for a few weeks to three months. It is then gradually decreased over a period of one year. Sometimes, prednisone can be given on an every other day dosage and sometimes it can be given for a 6 month duration, occasionally even shorter.Recurrences sometimes develop, but the medication can be restarted with eventual resolution over time.

Does corticosteroid treatment have side effects?

Yes, the adverse effects can be numerous, most are reversible but some are not. This medication will save a person's life, but can also cause difficulties in some individuals.

The common adverse reactions include increased appetite, weight gain, and bruising of the skin. A rounded puffy face, acne-like skin lesions, "fat pads" below the neck in the back and in the front may develop over time.Some psychological effects, high blood pressure, diabetes, and osteoporosis (softening of the bones) may develop. Cataracts can occur. A very rare condition known as aseptic necrosis of the hips requiring hip replacement may develop.It is important to obtain the list of side effects and review them.Some individuals have no difficulty with the medication. Others may be bothered by some of adverse reactions, but they are tolerated and disappear. Sometimes, a person cannot take the medication or develops a severe reaction.The prednisone is given at the lowest dose that is effective for the shortness length of time as possible. An every other day dosage can decrease the side effects.

What if corticosteroid therapy does not work?

There are several reasons why steroid therapy may not be effective.

First, the BOOP may not be typical and it may be an unusual form that does not respond to treatment.Second, the BOOP may be associated with scarring or fibrosis. In these situations, the scarring may stabilize or in unusual situations, the scarring progresses.Third, the BOOP is secondary to an underlying process referred to as idiopathic pulmonary fibrosis (IPF). In these situations, the steroid treatment is effective for the BOOP, but not for the pulmonary fibrosis.

Finally, the diagnosis may not be BOOP at all. It may be IPF or one of the interstitial pneumonias, or even an unusual tumor or infection.Because of these possibilities, it may be helpful to confirm the diagnosis by a lung pathologist.

Regarding other treatments, there have been anecdotal reports.In 1993, six patients in Japan were given erythromycin every day. After two months one patient responded and after three months of treatment, all six patients responded.In 1995, one patient was treated with inhaled corticosteroid inhaler for 8 months with a successful response.

Can BOOP be cured?

Yes, in patients whose BOOP disappears without treatment, it is cured.

BOOP is also cured in 65% to 80% of patients treated with prednisone. In the small percentage of patients who are not cured, the BOOP usually can be controlled by medications or it becomes stable.

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General Questions

Diagnosis

Types of BOOP

Books and Articles about Boop

Physicians Corner