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Bronchiolitis obliterans with Obstructive Pulmonary Disease

BOOP


Presentation

  • 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]
  • […] rapid progression (although some cases have more insidious course) Dry Cough (see Cough, [[Cough]]) Dyspnea (see Dyspnea, [[Dyspnea]]) Bone Marrow/Stem Cell Transplant-Associated Bronchiolitis Obliterans Onset Latency of Chronic GVHD : chronic GVHD presents[mdnxs.com]
  • 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]
  • They presented relatively persistent fever (15.5 vs. 7 days, p 0.000) and needed longer treatment in hospital (19.5 vs. 7 days, p 0.000).[springerplus.springeropen.com]
Increased Susceptibility to Infections
  • These changes may reflect chronic immune activation, increased susceptibility to infection (often related to immunomodulatory medications) or direct toxicity from disease modifying or biological therapy.[err.ersjournals.com]
Military Personnel
  • Newly reported respiratory symptoms and conditions among military personnel deployed to Iraq and Afghanistan: a prospective population-based study. Am J Epidemiol 2009 ;170: 1433 - 1444 3. The Iowa Persian Gulf Study Group.[nejm.org]

Treatment

  • 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]
  • 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]
  • Given the rarity of these diseases, the treatments outlined in the abstracts are not always evidence based. The information in the abstracts isnot intended to replace existing local, regional or country specific recommendations and guidelines.[orpha.net]
  • treatment Medication as needed GOLD A No long-term treatment, but is treated when symptomatic Monotherapy as in severity B Short-acting β2-agonist and/or Short-acting parasympatholytics GOLD B Monotherapy: long-acting bronchodilator Combination therapy[amboss.com]

Prognosis

  • 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]
  • Diagnosis - Bronchiolitis obliterans with obstructive pulmonary disease Prognosis - Bronchiolitis obliterans with obstructive pulmonary disease Not supplied.[checkorphan.org]
  • The prognosis of obstructive bronchiolitis is poor compared with BOOP.[hopkinsarthritis.org]
  • Treatment is largely supportive and prognosis is mainly related to the underlying cause and to the severity of the initial insult. a Pediatric Pulmonary Section, Department of Pediatrics, Texas Children 's Hospital, USA b Baylor College of Medicine, Houston[journals.lww.com]
  • Once diagnosed, the prognosis is extremely unfavorable. BOS carries a mortality rate of approximately 40-60%, with a five year survival rate of 13%. Early on, BOS is symptomatically silent.[clinicaltrials.gov]

Etiology

  • They are organised into groups, and further divided into clinical, etiological or histopathological sub-types.[orpha.net]
  • 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]
  • Organizing pneumonia (OP) is a histological pattern of alveolar inflammation with varied etiology (including pulmonary infection).[radiopaedia.org]
  • In many cases, the etiology remains unknown.[ncbi.nlm.nih.gov]
  • Etiology Exogenous factors Tobacco use ( 90% of cases) Patients with a smoking history of 20–30 pack years have an 80 –90% risk of developing COPD.[amboss.com]

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]
  • Epidemiologic, clinical and radiologic features. Chest 1982 ; 81 : 605 –9. Purkayastha A, Su J, McGraw J, et al.[thorax.bmj.com]
  • References: [1] Epidemiology References: [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Introduction Reports of respiratory symptoms have been common among soldiers who have served in the Middle East, beginning in the 1990s and more recently in soldiers returning from Iraq and Afghanistan. 1,2 Epidemiologic studies in the United States,[nejm.org]
  • There also have been only a few epidemiologic studies, mostly cross-sectional rather than longitudinal studies. So, what happens with these patients over time? Additionally, the tools for evaluating this disease have changed.[hopkinsarthritis.org]
Sex distribution
Age distribution

Pathophysiology

  • 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]
  • Not considered pathological, but a normal consequence of aging References: [5] [2] [10] Pathophysiology Chronic inflammation of the airways characterized by an increased number of neutrophils, macrophages, and T lymphocytes : Goblet cell proliferation[amboss.com]
  • The role of inflammation in the pathophysiology of CF lung disease. Clin Rev Allergy Immunol. 2002;23:5-23. [ Links ] 6 Bacharier LB, Boner A, Carlsen KH, Eigenmann PA, Frischer T, Götz M, et al.[scielo.br]
  • Those in their mid-40s who have normal FEV 1 values, however, probably will not develop symptomatic disease. 13 Pathophysiology COPD involves a chronic inflammatory process, primarily in the peripheral airways and the lung parenchyma.[aafp.org]

Prevention

  • Evaluation of interventions to prevent bronchiolitis obliterans relies on early detection of abnormal spirometry results or unusual decreases in repeated measurements.[checkorphan.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]
  • Additionally, the role of inhaled antibiotics used to prevent or suppress bacterial infection in the prevention or management of BOS needs to be determined.[erj.ersjournals.com]
  • Article Sources Centers for Disease Control & Prevention and the National Institute for Occupational Safety and Health. Flavorings-Related Lung Disease fact sheet. Ditschkowski M et al.[verywell.com]

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