1/7. macrolides: a treatment alternative for bronchiolitis obliterans organizing pneumonia?Some macrolides have been found to exert anti-inflammatory effects. lung diseases such as asthma, panbronchiolitis, cystic fibrosis, and bronchiectasis are thought to respond to the immunomodulatory properties of macrolides. We report three cases of idiopathic bronchiolitis obliterans organizing pneumonia, now called cryptogenic organizing pneumonia, and three cases of radiation-related bronchiolitis obliterans organizing pneumonia that responded to macrolide therapy. An explanation of why macrolides may have anti-inflammatory effects in patients with these syndromes is discussed. These cases help to reinforce accumulating data that macrolides are beneficial as anti-inflammatory agents and organizing pneumonia may be another pulmonary disease that can benefit from such therapy.- - - - - - - - - - ranking = 1keywords = bronchiolitis (Clic here for more details about this article) |
2/7. Importance of chronic aspiration in recipients of heart-lung transplants.In a series of eleven recipients of heart-lung transplants (HLT), five have obliterative bronchiolitis. Five of the eleven patients have chronic cough as well as slower than normal gastric emptying and/or oesophageal dysmotility; all five have evidence of bronchiectasis and three have obliterative bronchiolitis. Three of the patients improved after the introduction of treatment to prevent reflux, and another, who had a large phytobezoar, improved after pyloroplasty. In patients with chronic cough after HLT, with or without dyspeptic symptoms or recurring pulmonary sepsis, investigation of oesophageal motility and gastric emptying should be undertaken.- - - - - - - - - - ranking = 0.28571428571429keywords = bronchiolitis (Clic here for more details about this article) |
3/7. Obliterative bronchiolitis due to mycoplasma pneumoniae infection in a child.A 6-year-old girl presented with mycoplasma pneumoniae involving the right upper and lower lobes. She made a slow but complete recovery with resolution of the radiological changes. She re-presented 5 years later with a productive cough, recurrent wheezing and physical and radiological signs suggestive of obliterative bronchiolitis. This diagnosis was confirmed by ventilation - perfusion (V/Q) lung scan, and bronchography. The case highlights the value of V/Q scanning in the diagnosis of obliterative bronchiolitis and confirms the previous reports that mycoplasma infections are not always benign.- - - - - - - - - - ranking = 0.85714285714286keywords = bronchiolitis (Clic here for more details about this article) |
4/7. Swyer-James syndrome: bronchoalveolar lavage findings in two patients.Swyer-James syndrome (SJS) is a rare constrictive bronchiolitis that appears to be the result of acute bronchiolitis in infancy or early childhood. In the present study the cytological and immunophenotypical profile of bronchoalveolar lavage (BAL) was studied in two patients with SJS who showed a different spectrum of clinical outcome. The total BAL yield was markedly increased in the patient with chronic cough and acute episodes of dyspnoea but not in the patient with decreased exercise tolerance and longer duration of disease. In the two patients, the differential cell counts in percentage were characterized by a significant increase of neutrophils and a slight increase of lymphocytes. The analysis of lymphocyte subsets showed a significant increase of CD8 cells (T-suppressor-cytotoxic) in both cases, resulting in a decreased CD4/CD8 ratio. In addition, an increase of cells bearing a B-phenotype (CD19 cells) was noted in the fluid recovered from the patient with chronic cough and acute episodes of dyspnoea. In conclusion, our data suggest that SJS is an active process with inflammatory characteristics. Further studies are needed to explain the mechanism leading to the expansion in situ of immunocompetent cells.- - - - - - - - - - ranking = 0.28571428571429keywords = bronchiolitis (Clic here for more details about this article) |
5/7. Infections due to parainfluenza virus type 4 in children.Parainfluenza viruses are a major cause of hospitalization for respiratory illness in children. The spectrum of clinical illness associated with infection due to parainfluenza type 4 virus has not been well defined. It is technically difficult to isolate the virus in tissue culture, and because illness is generally reported to be mild, in many cases, patients may not seek medical attention. We describe a series of 10 children with parainfluenza type 4 virus infection who were seen at the Montreal Children's Hospital between 1988 and 1992. There were five males and five females whose average age was 29.7 months. Infection was associated with symptoms of bronchiolitis or pneumonia in 5 children, paroxysmal coughing in 3 infants, apnea in 1 newborn, and aseptic meningitis in 1 child. hospitalization was required for 8 of the 10 children. It appears that infection with parainfluenza type 4 virus may be more common than previously recognized, and it may be associated with more severe infections.- - - - - - - - - - ranking = 0.14285714285714keywords = bronchiolitis (Clic here for more details about this article) |
6/7. Cryptogenic constrictive bronchiolitis. A clinicopathologic study.Four women with a chronic respiratory illness characterized by chronic cough, dyspnea, mild to severe physiologic abnormalities, relatively normal chest radiographs, and lack of response to bronchodilators or prednisone were identified and prospectively evaluated. Constrictive bronchiolitis, defined as concentric narrowing of the bronchiolar lumen, mural scarring, smooth muscle hyperplasia, and mucus stasis, was the major histologic finding on open lung biopsy in all cases. Each presented with an illness clinically distinct from asthma, connective tissue disorders, occupational or environmental lung disease, bronchiectasis, diffuse panbronchiolitis, cystic fibrosis, and emphysema. None of the patients smoked cigarettes. None had clinical evidence of a recent viral lower respiratory tract infection. The physical examinations were normal except for rales heard on chest examination in two patients. Chest radiographs showed increased bronchovascular markings in three patients. Lung function was normal in one patient, two of the patients had a reduced diffusing capacity associated with moderate hypoxemia and an obstructive ventilatory defect, and one patient exhibited a mixture of restrictive and obstructive defects. None have experienced significant progression of their disease over 1 to 5 yr of follow-up. However, complete return to normal function did not occur. We hypothesize that patients with the constellation of findings described represent a distinct and definable clinicopathologic entity and further clarifies the spectrum of "small airways disease." Establishing the diagnosis appears important for prognostic and possibly therapeutic reasons.- - - - - - - - - - ranking = 0.85714285714286keywords = bronchiolitis (Clic here for more details about this article) |
7/7. Granulomatous bronchiolitis associated with Crohn's disease.Symptomatic bronchopulmonary disorders have been only occasionally reported in Crohn's disease, although several studies have documented the possibility of latent involvement of the respiratory tract. We report the case of a patient with long-standing Crohn's disease who presented with acute transient chest pain and a recent history of mild dyspnea and nonproductive cough. Chest radiographs were normal, while high-resolution computed tomography demonstrated a mosaic pattern of attenuation that was consistent with a bronchiolar disorder. Pulmonary function tests showed mild airway obstruction and normal diffusion indices. Thoracoscopic lung biopsy demonstrated focal infiltration of the bronchiolar walls by mononuclear cells and non-necrotizing granulomas. To our knowledge, this is the first account of isolated granulomatous bronchiolitis in Crohn's disease. These findings suggest that a granulomatous inflammatory process of the bronchioles could be involved in the development of airway obstruction in patients with Crohn's disease.- - - - - - - - - - ranking = 0.71428571428571keywords = bronchiolitis (Clic here for more details about this article) |