Diffuse panbronchiolitis in a Caucasian man in Canada.

Area of Science:

• Pulmonology
• Internal Medicine
• Radiology

Background:

• Diffuse panbronchiolitis (DPB) is a rare chronic bronchiolar disease, often overlooked in Western countries.
• It typically affects nonsmokers, presenting with airflow obstruction, chronic cough, and nodular lung opacities.
• Untreated DPB has a poor prognosis.

Purpose of the Study:

• To report a case of DPB in a Caucasian patient from Canada, highlighting its occurrence outside of Asian populations.
• To emphasize the importance of considering DPB in the differential diagnosis of persistent airflow obstruction with radiographic abnormalities.
• To illustrate the potential benefits of antibiotic therapy in managing DPB.

Main Methods:

• Case report of a Caucasian male with progressive respiratory symptoms.
• Diagnostic workup included chest computed tomography (CT) and lung biopsy.
• Treatment involved clarithromycin, with clinical and functional assessments.

Main Results:

• Chest CT revealed diffuse centrilobular opacities.
• Lung biopsy confirmed chronic bronchiolitis with characteristic inflammatory cell infiltration.
• The patient showed significant improvement after two months of clarithromycin therapy.

Conclusions:

• DPB should be considered in Western patients presenting with persistent airflow obstruction and nodular lung shadows.
• Prompt diagnosis and treatment, potentially with macrolide antibiotics, can lead to clinical improvement.
• Increased physician awareness is necessary for timely diagnosis and management of DPB in diverse populations.