Presentation
Veterans present with shortness of breath and other asthma-like symptoms. The only way to diagnose this condition is by doing a lung biopsy as chest X-rays and CT scans come back as normal. [en.wikipedia.org]
About 5% to 14% of HSCT recipients also develop bronchiolitis obliterans syndrome which is pulmonary graft vs. host disease and can present several months to years after transplantation. [ncbi.nlm.nih.gov]
Over time, however, a number of soldiers without exposure to the sulfur-mine fire presented with similar exercise limitations. [nejm.org]
In the cardiac evaluation, the patient presented no abnormalities, and the echocardiogram showed no evidence of pulmonary hypertension. [scielo.br]
Grunstein Abstract Author Information Authors Article Metrics Metrics In this review, we discuss recent advances in our understanding of the etiology, pathology and pathogenesis, clinical presentation, diagnosis, treatment, and outcome of bronchiolitis [journals.lww.com]
Entire Body System
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Eosinophilic Asthma
asthma ( J82 ) miner's asthma ( J60 ) wheezing NOS ( R06.2 ) wood asthma ( J67.8 ) Type 2 Excludes asthma with chronic obstructive pulmonary disease ( J44.9 ) chronic asthmatic (obstructive) bronchitis ( J44.9 ) chronic obstructive asthma ( J44.9 ) Use [icd10data.com]
Jaw & Teeth
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Oral Ulcers
Cases of bronchiolitis obliterans associated with Castleman’s disease may also have paraneoplastic pemphigus which may present with oral ulcers as well as lymphadenopathy. Evaluation Pulmonary function testing is essential for diagnosis. [ncbi.nlm.nih.gov]
Musculoskeletal
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Joint Stiffness
History may also elicit recent exposure to toxic fumes or gases, viral infections, symptoms of joint stiffness in cases of rheumatoid arthritis, prior lung or hematopoietic stem cell transplantation. [ncbi.nlm.nih.gov]
Workup
• Careful history taking, physical exam, and meticulous workup are needed to rule out other similar differential diagnoses. • More sinister synucleinopathies, like multiple system atrophy, often start with a clinical picture that is very similar to [medlink.com]
Workup may be performed if there is concern for an underlying inflammatory etiology. Physical examination A complete ophthalmic examination should be performed. [eyewiki.aao.org]
Treatment
Completed NCT01009619 Phase 4 Azithromycin;Placebo 6 Aztreonam Lysine for Inhalation (AZLI) in the Treatment of Early Bronchiolitis Obliterans Syndrome (BOS) After Lung Transplantation Completed NCT01469364 Phase 4 Aztreonam Lysine for Inhalation (AZLI [malacards.org]
Specific Treatment of Toxic Fume-Associated Bronchiolitis Obliterans General Comments : there is no curative treatment Bronchodilators Shown to be useful in sulfur mustard gas-associated cases [ MEDLINE ] Inhaled Corticosteroids (see Corticosteroids, [mdnxs.com]
Treatment / Management Treatment of bronchiolitis obliterans syndrome after lung transplant involves augmenting immunosuppression since it is thought to be a form of chronic rejection. [ncbi.nlm.nih.gov]
The focus is on the pathobiology of COPD and emphysema, on the exacerbation of COPD and on treatment options. [books.google.com]
Treatment - Bronchiolitis obliterans with obstructive pulmonary disease This disease is irreversible and severe cases often require a lung transplant. [checkorphan.org]
Prognosis
Diagnosis - Bronchiolitis obliterans with obstructive pulmonary disease Prognosis - Bronchiolitis obliterans with obstructive pulmonary disease Not supplied. [checkorphan.org]
Epler-Colby Prognostic Classification (1983) Toxic Fume Exposure-Associated BO : poor-good prognosis with steroid therapy Early steroid use may alter progression Post-Infection-Associated BO : fair-good prognosis with steroids therapy Connective Tissue [mdnxs.com]
Progression and prognosis in pure autonomic failure (PAF): comparison with multiple system atrophy. Mabuchi N et al., J Neurol Neurosurg Psychiatry. 2005 Jul;76(7):947-52. 4. [dysautonomiainternational.org]
10–15% functional recovery; if no recovery is evident and progressive after 24 hours, prognosis is poor Vibration and proprioception are typically spared because of an intact dorsal column! [amboss.com]
Pearls and Other Issues Prognosis of patients with bronchiolitis obliterans is poor, and some may have a rapid decline in lung function. [ncbi.nlm.nih.gov]
Etiology
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
Etiology Several risk factors can lead to the development of bronchiolitis obliterans. It is one of the most common noninfectious complications after lung transplant and hematopoietic stem cell transplantation. [ncbi.nlm.nih.gov]
History 1835 : bronchiolitis obliterans was first described by Reynaud Classification of Bronchiolar Disorders Etiology Infection General Comments Cases occur predominantly in children Prevalence of post-infection BO is presumed to be low (considering [mdnxs.com]
A spine MRI is the diagnostic modality of choice to determine the etiology, level, and extent of the lesion. Treatment depends on the underlying etiology. [amboss.com]
Organizing pneumonia (OP) is a histological pattern of alveolar inflammation with varied etiology (including pulmonary infection). [radiopaedia.org]
Epidemiology
only a few reported cases Polydermatomyositis (see Polydermatomyositis, [[Polydermatomyositis]]) Epidemiology : only a few reported cases Post-Bone Marrow Transplant/Stem Cell Transplant (BMT/SCT) (see Bone Marrow Transplant, [[Bone Marrow Transplant [mdnxs.com]
Terminology Also called sideropenic dysphagia Epidemiology Occurs mostly in Scandinavia and Great Britain Usually women ages 30 years Treatment Iron supplements, mechanical dilation and monitor for upper GI carcinoma Clinical images Images hosted on other [pathologyoutlines.com]
Epidemiology Bronchiolitis obliterans syndrome is considered a form of chronic allograft rejection after lung transplantation. The majority of lung transplant recipients who are long term survivors develop bronchiolitis obliterans syndrome. [ncbi.nlm.nih.gov]
2008 Allowable Qualifiers English: BL blood CF cerebrospinal fluid CI chemically induced CL classification CO complications CN congenital DI diagnosis DG diagnostic imaging DH diet therapy DT drug therapy EC economics EM embryology EN enzymology EP epidemiology [decs.bvs.br]
Epidemiologic, clinical and radiologic features. Chest 1982 ; 81 : 605 –9. Purkayastha A, Su J, McGraw J, et al. [thorax.bmj.com]
Pathophysiology
Pathophysiology In response to injury from inhalational toxins or autoimmune responses, there is inflammation of subepithelial structures and dysregulated repair, leading to fibroproliferation and abnormal regeneration of epithelium of the small airways [ncbi.nlm.nih.gov]
Pathophysiology, diagnosis and treatment. Tykocki T et al., Kardiol Pol. 2010 Sep;68(9):1057-63. [dysautonomiainternational.org]
The author details the clinical features, pathogenesis and pathophysiology, and the often times difficult differential diagnosis. [medlink.com]
This predominance of sympathetic activity may contribute to the pathophysiology of cardiovascular disease and could result from changes in the breathing pattern, high levels of catecholamines or the permanently increased level of work associated with [omicsonline.org]
DAH develops in 10% to 21% of HSCT recipients. 77, 78 Despite the presence of thrombocytopenia in most, DAH is not corrected with platelet transfusions. 77 The pathophysiology of DAH is not clearly understood. [nature.com]
Prevention
Evaluation of interventions to prevent bronchiolitis obliterans relies on early detection of abnormal spirometry results or unusual decreases in repeated measurements. [checkorphan.org]
Bronchiolitis Obliterans Syndrome After Lung Transplantation Completed NCT01212406 Phase 4 Vitamin D 5 Randomized Double-blind Placebo-controlled Prevention Trial of Azithromycin in Lung Transplantation. [malacards.org]
Evaluation of interventions to prevent obliterative bronchiolitis relies on early detection of abnormal spirometry results or unusual decreases in repeated measurements. [en.wikipedia.org]
Clin Transplant 2011;25:E381-9 [ MEDLINE ] A randomised controlled trial of azithromycin to prevent chronic rejection after lung transplantation. [mdnxs.com]
In addition, they should take preventive measures to reduce exposure to diacetyl and other flavoring chemicals. See below for medical guidelines and prevention information. [cdph.ca.gov]