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Respiratory bronchiolitis associated interstitial lung disease (RB-ILD) presenting with haemoptysis.

A M McWilliams1, F R Lake

  • 1Department of Respiratory Medicine, Royal Perth Hospital, Western Australia, Australia. annemcw@hotmail.com

Respirology (Carlton, Vic.)
|February 24, 2001
PubMed
Summary

Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) is rare in smokers. This case highlights RB-ILD presenting with significant hemoptysis, requiring lung biopsy for diagnosis, with limited long-term lung function improvement.

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Area of Science:

  • Pulmonology
  • Thoracic Medicine
  • Internal Medicine

Background:

  • Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) is an uncommon interstitial lung disease predominantly affecting current or former smokers.
  • While typically presenting with non-specific respiratory symptoms, hemoptysis is an unusual manifestation of RB-ILD.

Observation:

  • A 25-year-old woman presented with significant hemoptysis and dyspnea, despite a normal clinical examination and normal chest radiology.
  • Extensive investigations ruled out other common causes of hemoptysis.
  • Diagnosis was confirmed via thoracoscopic lung biopsy, revealing RB-ILD.

Findings:

  • The patient experienced significant postoperative complications, including prolonged air leak and hydropneumothorax, necessitating further surgical intervention.

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  • Despite smoking cessation advice, pulmonary function tests remained abnormal at follow-up, although her symptoms improved.
  • This case underscores that RB-ILD can present with normal physical examination and radiological findings.

    • Implications:

    • Hemoptysis in the context of RB-ILD may be directly related to the lung pathology or coincidental.
    • Diagnosis of RB-ILD often necessitates invasive procedures like lung biopsy.
    • Pulmonary function in patients with RB-ILD may not significantly recover even after diagnosis and treatment.