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Diffuse panbronchiolitis in a Caucasian man in Canada.

Alessandra Sandrini1, M S Balter, Kenneth R Chapman

  • 1Division of Respiratory Medicine, Department of Medicine, University of Toronto, Ontario, Canada.

Canadian Respiratory Journal
|December 18, 2003
PubMed
Summary

Diffuse panbronchiolitis (DPB), a rare lung disease, can affect non-Asian populations. Early diagnosis and treatment with antibiotics like clarithromycin are crucial for improving outcomes in patients with persistent airflow obstruction.

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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.

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  • 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.