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Severe cryptogenic bronchiolitis: Case report.
Luis Eduardo Ramírez1, María Alejandra Amézquita2, Eliana Isabel Morales3,4
1Department of Internal Medicine, Pulmonology Fellow Program, Universidad Nacional, Bogotá, Colombia.
Respiratory Medicine Case Reports
|September 4, 2023
Summary
Bronchiolitis obliterans, a progressive airway fibrotic disease, can present variably. Lung transplantation offers a successful treatment option for severe cases, improving patient outcomes.
Area of Science:
- Pulmonology
- Pathology
- Transplant Surgery
Background:
- Bronchiolitis obliterans (BO), also known as constrictive bronchiolitis, is a serious fibrotic airway disease.
- It is linked to stem cell transplants, lung transplants, toxin exposure, infections, and autoimmune conditions, or can be idiopathic (cryptogenic).
Observation:
- A 52-year-old man with comorbidities presented with dyspnea and cough.
- Initial tests suggested hypersensitivity pneumonitis, but lung biopsy confirmed constrictive bronchiolitis.
- The patient's condition worsened, necessitating bilateral lung transplantation.
Findings:
- Lung biopsy confirmed extensive constrictive bronchiolitis.
- Bilateral lung transplantation was successfully performed.
- The patient demonstrated good recovery and functional improvement post-transplant.
Implications:
- Bronchiolitis obliterans has a variable prognosis, with higher mortality in allogeneic HSCT.
- Toxic inhalation-related BO is typically nonprogressive; autoimmune or cryptogenic forms are rare and heterogeneous.
- Accurate diagnosis requires integrating clinical history, imaging, and histology.
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