| Bronchiolitis obliterans[1] | |
|---|---|
| Other names | Constrictive bronchiolitis,[2] Obliterative bronchiolitis, Popcorn lung |
 | |
| High resolution CT scan showing bronchiolitis obliterans with mosaic attenuation, bronchiectasis, air trapping and bronchial thickening[3] | |
| Specialty | Pulmonology  |
| Symptoms | Dry cough, shortness of breath, wheezing, feeling tired[1] |
| Usual onset | Worsens over weeks to months in rare cases.[4] |
| Causes | Toxic fumes, respiratory infections, connective tissue disorder, following a bone marrow or heart-lung transplant[1] |
| Diagnostic method | CT scan, pulmonary function tests, lung biopsy[1] |
| Differential diagnosis | Asthma[5] |
| Treatment | Corticosteroids, immunosuppressive medication, lung transplant[1][4] |
| Prognosis | Often poor[4] |
| Frequency | Rare[4] |
Bronchiolitis obliterans (BO), also known as obliterative bronchiolitis, constrictive bronchiolitis and popcorn lung, is a disease that results in obstruction of the smallest airways of the lungs (bronchioles) due to inflammation.[1][6] Symptoms include a dry cough, shortness of breath, wheezing and feeling tired.[1] These symptoms generally get worse over weeks to months.[4] It is not related to cryptogenic organizing pneumonia, previously known as bronchiolitis obliterans organizing pneumonia.[4]
Causes include breathing in toxic fumes, respiratory infections, connective tissue disorder or complications following a bone marrow or heart-lung transplant.[1] Symptoms may not occur until two to eight weeks following toxic exposure or infection.[1] The underlying mechanism involves inflammation that results in scar tissue formation.[1] Diagnosis is by CT scan, pulmonary function tests or lung biopsy.[1] A chest X-ray is often normal.[4]
While the disease is not reversible, treatments can slow further worsening.[1] This may include the use of corticosteroids or immunosuppressive medication.[1] A lung transplant may be offered.[4] Outcomes are often poor, with most people dying in months to years.[4]
Bronchiolitis obliterans is rare in the general population.[4] It, however, affects about 75% of people by ten years following a lung transplant and up to 10% of people who have received a bone marrow transplant from someone else.[4] The condition was first clearly described in 1981.[4] Prior descriptions occurred as early as 1956, with the term "bronchiolitis obliterans" used first by Reynaud in 1835.[7][8]
- ^ a b c d e f g h i j k l m "Bronchiolitis obliterans". GARD. 2012. Archived from the original on 21 January 2017. Retrieved 13 September 2016.
- ^ Schlesinger C, Meyer CA, Veeraraghavan S, Koss MN (October 1998). "Constrictive (obliterative) bronchiolitis: diagnosis, etiology, and a critical review of the literature". Annals of Diagnostic Pathology. 2 (5): 321–34. doi:10.1016/S1092-9134(98)80026-9. PMID 9845757.
- ^ Xie BQ, Wang W, Zhang WQ, Guo XH, Yang MF, Wang L, et al. (2014). "Ventilation/perfusion scintigraphy in children with post-infectious bronchiolitis obliterans: a pilot study". PLOS ONE. 9 (5): e98381. Bibcode:2014PLoSO...998381X. doi:10.1371/journal.pone.0098381. PMC 4031120. PMID 24852165.
- ^ a b c d e f g h i j k l Lynch JP, Weigt SS, DerHovanessian A, Fishbein MC, Gutierrez A, Belperio JA (October 2012). "Obliterative (constrictive) bronchiolitis". Seminars in Respiratory and Critical Care Medicine. 33 (5): 509–32. doi:10.1055/s-0032-1325161. PMID 23001805. S2CID 29669937.
- ^ Lockey RF, Ledford DK (2014). Asthma: Comorbidities, Coexisting Conditions, and Differential Diagnosis. Oxford University Press. p. 111. ISBN 9780199918072. Archived from the original on 2017-09-08.
- ^ Barker AF, Bergeron A, Rom WN, Hertz MI (May 2014). "Obliterative bronchiolitis". The New England Journal of Medicine. 370 (19): 1820–8. doi:10.1056/NEJMra1204664. PMID 24806161.
- ^ Gosink BB, Friedman PJ, Liebow AA (April 1973). "Bronchiolitis obliterans. Roentgenologic-pathologic correlation". The American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine. 117 (4): 816–32. doi:10.2214/ajr.117.4.816. PMID 4698820.
- ^ Gourtsoyiannis NC, Ros PR (2005). Radiologic-Pathologic Correlations from Head to Toe: Understanding the Manifestations of Disease. Springer Science & Business Media. p. 154. ISBN 9783540266648. Archived from the original on 2017-09-08.