| Clinical characteristics of diffuse panbronchiolitis. |
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Young Whan Kim, Chul Gyu Yoo, Sung Koo Han, Young Soo Shim, Keun Youl Kim, Yong Chol Han |
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Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea |
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| Abstract |
Background
Diffuse panbronchiolitis (DPB) is a chronic obstructive pulmonary disease distinguished from bronchial asthma, chronic bronchitis, pulmonary emphysema, bronchiectasis, or alveolitis. It is prevalent in Japan, but is known to be rare outside of Japan. Only a few cases in Chinese, Italian, North American and Korean have been reported. During recent two years, we have found 16 cases of DPB in Seoul National University Hospital and analyzed the clinical characteristics.
Methods
We reviewed the patients’ age, sex, duration of illness, smoking history, occupational history, and past medical history. And we analyzed patients’ symptoms, physical signs, laboratory findings, and responses to treatment.
Results
1) Male: female ratio was 2. 2:1, the ages ranged from 27 to 72 years old, and the duration of disease varied from 1 to 20 years.
2) Most of the patients were being treated as bronchiectasis, miliary tuberculosis, chronic bronchitis or bronchial asthma before they were diagnosed as DPB 3) Only one patient was a smoker, and 25% of patients had the occupational history of exposure to particles or gas. And all patients had paranasal sinusitis 4) High resolution computed tomography (HRCT) was very useful in diagnosing the disease in most of the patients 5) PFT showed obstructive and restrictive abnormalities, and blood gas revealed hypoxemia in most of the patients.
6) Pseudomonas aeruginosa was isolated in the sputum of four patients (25%).
7) The titèrs of cold hemaglutinin, RA factor and CRP were elevated in most of the patients.
8) Most of the patients improved after treatment with erythromycin.
Conclusion
DPB might not be a rare disease in Korea. So DPB should be suspected in a patient who has chronic cough, sputum, dyspnea and diffuse fine nodular chest X-ray abnormality. HRCT and open lung biopsy should be considered in a patient suspected of DPB |
| Key Words:
Diffuse panbronchiolitis, Korean, open lung biopsy, High resolution computed tomography |
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