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Diffuse panbronchiolitis in the United States

J E Fitzgerald1, T E King, D A Lynch

  • 1Department of Medicine, University of Colorado Health Sciences Center, Denver 80262, USA.

American Journal of Respiratory and Critical Care Medicine
|August 1, 1996
PubMed
Summary
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Diffuse panbronchiolitis (DPB), a lung disease previously seen in the Far East, is now identified in US citizens. Early diagnosis and macrolide therapy offer improved prognosis for this obstructive lung disease.

Area of Science:

  • Pulmonology
  • Radiology
  • Pathology

Background:

  • Diffuse panbronchiolitis (DPB) is a sinobronchial syndrome causing progressive obstructive lung disease, predominantly reported in the Far East.
  • DPB is characterized by specific radiologic and histologic findings.

Observation:

  • Five US citizens, without Far East travel history, were diagnosed with DPB.
  • Patients presented with chronic sinusitis, cough, dyspnea, sputum, severe airflow limitation, and overdistention on pulmonary function tests.
  • HRCT scans showed centrilobular nodules with thickened and dilated bronchioles; lung biopsies revealed bronchiolocentric inflammation.

Findings:

  • Clinical, radiographic, and histologic features in these US patients closely resemble those of Japanese DPB patients.
  • Three patients are alive and undergoing chronic macrolide therapy.

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Implications:

  • DPB should be considered in the differential diagnosis of sinopulmonary syndromes and obstructive lung disease in the US.
  • Early recognition and treatment with macrolides can improve outcomes for DPB patients.