A Case of Bronchiolitis Obliterans Organizing Pneumonia Complicating Diabetes Mellitus

Abstract

X-ray films of a 61-year-old man with diabetes mellitus under treatment showed migrating pulmonary infiltrates that did not respond to antibiotics. Chest CT scanning revealed a mixture of parenchymal and interstitial lesions. Histological examination after transbronchial lung biopsy showed organizing pneumonia accompanied by alveolitis. Based on these findings together with clinical findings, a diagnosis of bronchiolitis obliterans organizing pneumonia (BOOP) was made. Though steroid therapy was markedly effective, its discontinuation resulted in relapse. In patients with diabetes mellitus, an infectious lung disease often persists because of impaired mechanisms for healing airway infection caused by decreased neutrophil function, and cellular immunity, neuropathy, and microangiopathy. However, when pulmonary infiltrate shadows do not show a responce to antibiotics, early histological examination should be performed, considering the possibility of BOOP.