Bronchiolitis obliterans with organizing pneumonia (BOOP) heralding anti-Jo-1-positive polymyositis.


We report a 51-year-old man who presented with 3 weeks of polyarthritis with fever, nonproductive cough, bibasilar crackles, tachypnea, and hypoxia. Initial laboratory data showed an increased erythrocyte sedimentation rate, rheumatoid factor, and anti-Jo-1 antibody. Imaging studies showed bilateral lower lobe infiltrates of the lung. A transbronchial biopsy specimen revealed characteristic findings for bronchiolitis obliterans organizing pneumonia (BOOP). About 6 months later, he developed profound proximal muscle weakness with a dramatic increase in creatine phosphokinase and aldolase and a further elevation of anti-Jo-1. Muscle biopsy specimen findings were consistent with polymyositis.This represents an unusual case in which BOOP occurred at the onset of an illness initially suggestive of rheumatoid arthritis (RA). The anti-Jo-1-positivity led to close follow up and later discovery of evolution into polymyositis. BOOP can be an early feature of polymyositis as well as RA.

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@article{Xing1999BronchiolitisOW, title={Bronchiolitis obliterans with organizing pneumonia (BOOP) heralding anti-Jo-1-positive polymyositis.}, author={M Xing and Thomas Franklin Lansdale and Cynthia F McNamara and H W Hauptman and L Tao and R. Kantor and Ravinder Singh Pabla and Ganesh Shenoy and Eugene A. Obah and Gabriele Bedon}, journal={Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases}, year={1999}, volume={5 4}, pages={219-23} }