Bronchiolitis Obliterans Organizing Pneumonia Due to Gastroesophageal Re

The most common causes of bronchiolitis obliterans organizing pneumonia (BOOP) are connective tissue diseases, organ transplantation, drug reaction, and infections. Although rare, BOOP due to gastroesophageal re fl ux (GER) has been reported in adults but not to date in pediatric patients. This study describes 2 pediatric patients who developed GER and BOOP. One patient had superior mesenteric artery syndrome and Helicobacter pylori infection, and the other had a gastroduodenal ulcer with re fl ux esophagitis. Respiratory symptoms occurred concurrently or after gastrointestinal symptoms. Monitoring of esophageal pH for 24 hours revealed pathologic acid re fl ux. Lung biopsy fi ndings con fi rmed BOOP. No other causes of BOOP were observed in these 2 patients. Both patients were cured with antire fl ux therapy and corticosteroids. To our knowledge, this is the fi rst case report to implicate GER as a reversible cause of BOOP in children.

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