Diffuse Aspiration Bronchiolitis With Neuromyelitis Optica Spectrum Disorder.

Area of Science:

• Pulmonology
• Neurology
• Immunology

Background:

• Diffuse aspiration bronchiolitis (DAB) is a chronic lung condition typically seen in older adults with dysphagia.
• It results from repeated aspiration of foreign materials into the bronchioles.
• Neuromyelitis optica spectrum disorder (NMOSD) is a rare autoimmune disease affecting the central nervous system.

Observation:

• A woman in her 40s presented with symptoms initially suggestive of pneumonia.
• Specific neurological abnormalities related to NMOSD were noted.
• Diffuse centrilobular opacities were observed on imaging, characteristic of DAB.

Findings:

• The patient was diagnosed with DAB, presumed to be caused by NMOSD.
• This represents the first reported case of DAB associated with NMOSD.
• The diagnosis was delayed due to the absence of clear aspiration history and prominent pneumonia symptoms.

Implications:

• DAB should be considered in younger patients presenting with diffuse lung opacities, even without obvious dysphagia.
• NMOSD should be investigated in patients with unexplained DAB and neurological signs.
• This case expands the known spectrum of neurological conditions associated with DAB.