Bronchiolitis Obliterans Organizing Pneumonia Associated with Drug Poisoning: A Case Report

Bronchiolitis obliterans organizing pneumonia (BOOP) is characterized clinically by a sub-acute or chronic respiratory illness especially in adults. It’s defined pathogenetically as the existence of polypoid granulation tissue in the distal airways extending into the alveolar ducts and alveoli. It’s considered a form of interstitial pneumonia with airspace infiltration by mononuclear cells and foamy macrophages. It is a distinct response from the lung to the injury and based on research almost one-half of BOOP cases are idiopathic and the other half are as to secondary reaction to a variety of pulmonary injuries. For instance , some condition such as infections , drugs , radiotherapy , inflammatory bowel disease , immunological disorder , and melanoma and organ transplantation may participate BOOP.In this paper , we report a case of the 20-year-old male corpse with a history of hospitalization that referred to the department of legal medicine organization in Birjand to determine the cause of death. In microscopic histological examination of his lung tissue, we observed an unusual phenomenon; in some of the end bronchioles , Masson bodies were viewed in the form of mesenchymal tissue with a pale and kind of exudative appearance that which made of spindle cells with spindle nuclei and fibrillary cytoplasm arranged and fibrin deposits that have blockage the interior of the bronchial tubes. The case demonstrated BOOP with a history of drug abuse. Although no clear link has been made between drug poisoning and BOOP , it is the suggested etiology of this corpse’s hospitalization and pathology. Though based on research specified some narcotic agent’s causes of respiratory depression and thus predispose to aspiration Pneumonia. Also , Overdoses of opiates are known to precipitate bronchospasm. So increasing awareness and further studies will be needed to prove a causal relationship between drug poisoning and BOOP. When evaluating patients presenting with respiratory symptoms and a history of drug poisoning , one should consider BOOP in their differential diagnosis.

کلیدواژه ها:

Bronchiolitis oblitrans organizing pneumonia ، Forensic medicine ، drug abuse