Obliterative bronchiolitis is also called bronchiolitis obliterans and constrictive bronchiolitis. This is a rare and life threatening form of non-reversible obstructive lung disease. In this condition, bronchioles are narrowed and compressed by inflammation or fibrosis. Obliterative bronchiolitis is sometimes a severe form of pediatric bronchiolitis due to adenovirus.
Bronchiolitis refers to inflammation of bronchioles and obliterans means the fact that fibrosis or inflammation of bronchioles completely or partially obliterates airways.
Symptoms of Obliteratve Bronchiolitis:
Obliterative bronchiolitis is a lung disease that is characterized by obstruction in airways. Scarring and inflammation occur in the lung airways that results in dry cough and severe shortness of breath. Forced Expiratory Volume in a second (FEV1) must be < 80% of estimated values. Obliterative bronchiolitis reduces FEV1 to 16 – 21%.
Symptoms of obliterative bronchiolitis include:
- Wheezing
- Dry cough
- Shortness of breath
Symptoms may start gradually or the severe symptoms occur suddenly.
Causes of Obliterative Bronchiolitis:
Causes of obliterative bronchiolitis include:
- Transplant rejection while transplanting organs
- Stevens-Johnson Syndrome
- Drug reaction
- Collagen vascular disease
- Aspiration
- Exposure to toxic fumes. These include: sulfur dioxide, ammonia, thionyl chloride, hydrogen flouride, diacetyl, hydrogen bromide, nitrogen dioxide, hydrogen chloride, phosgene, hydrogen sulfide, mustard gas, ozone and poly-amine dyes.
- Viral Infection. This include: HIV, Adenovirus, Respiratory syncytial virus, cytomegalovirus
- Prematurity complications (Bronchopulmonary dysplasia)
- Rheumatoid arthritis
- Oral emergency medicines, like activates charcoal
Diagnosis for Obliterative Bronchiolitis:
Often, obliterative bronchiolitis is misdiagnosed as bronchitis, pneumonia, asthma or emphysema.
Diagnosis includes the following tests:
- Spirometry tests for detecting obstructions in airways and restrictions too. Hence, FEV1/FVC < 75%.
- Usually, diffusing capacity of lung tests are performed.
- Chest X-rays.
- Lung biopsies reveals the evidence of constrictive obliterative bronchiolitis. Thoracoscopy is more appropriate than transbronchial biopsy.
Treatment for Obliterative Bronchiolitis:
Bronchiolitis obliteran is irreversible and in severe cases, lung transplantation is required. Evaluation of interventions for preventing this disease relies on early identification of unusual decrease in repeated measurements or abnormal spirometry results.
