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bronchiolitis obliterans

ICD-10 Codes

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Description

Bronchiolitis obliterans (BO) is a rare and irreversible lung disease characterized by inflammation and scarring in the smallest airways of the lungs, known as bronchioles [1][4]. This condition leads to obstruction of these tiny airways, making it difficult for air to reach the lungs and causing symptoms such as:

  • Dry cough
  • Shortness of breath
  • Wheezing
  • Feeling tired

These symptoms typically worsen over weeks to months [1].

BO is a chronic condition that can be slowed down with available treatments, but not reversed. It's essential to catch the disease early when treatment is more likely to prevent further progression [4]. In some cases, BO can occur after lung transplantation or hematopoietic stem cell transplantation (HSCT), and is then referred to as bronchiolitis obliterans syndrome [11].

The condition can also be caused by exposure to harmful chemicals or particles, which can lead to inflammation in the airways [6]. In people who have had a lung transplant, about 50% will develop bronchiolitis obliterans syndrome within five years of their transplant procedure, and about 10% of recipients of donor marrow will also develop this condition [13].

Overall, BO is a serious lung disease that requires prompt medical attention to manage symptoms and slow down progression.

Signs and Symptoms

Bronchiolitis obliterans, also known as popcorn lung, is a rare and serious condition that affects the lungs. The signs and symptoms of this condition can vary from person to person, but here are some common ones:

  • Coughing: A persistent and dry cough is one of the most common symptoms of bronchiolitis obliterans. This cough may be worse during and after exercise or physical activity.
  • Shortness of breath: People with this condition often experience shortness of breath, which can make it difficult to breathe even when sitting still.
  • Wheezing: Wheezing is another common symptom, which can sound like a high-pitched whistling noise when breathing out.
  • Fatigue: Bronchiolitis obliterans can cause fatigue and weakness, making it hard to perform daily activities.

In some cases, people with this condition may also experience:

  • Fever: A low-grade fever is not uncommon in people with bronchiolitis obliterans.
  • Weight loss: Unintentional weight loss can occur due to the body's increased energy expenditure trying to breathe.
  • Chest tightness: Some people may feel a tightness or discomfort in their chest, which can be mistaken for other conditions like asthma.

It's essential to note that these symptoms can develop gradually over time and may worsen with physical activity or exposure to irritants. If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

  • [1] Signs and symptoms of popcorn lung include: Coughing, especially during and after exercise. Coughs may sometimes bring up mucus ... (Source 1)
  • [2] The main symptoms of popcorn lung are a dry cough and shortness of breath. These show up between 2 weeks and 2 months ... (Source 2)
  • [3] Core signs of popcorn lung include a dry cough, fever, weight loss, wheezing, and shortness of breath. (Source 13)

Additional Symptoms

Diagnostic Tests

Bronchiolitis obliterans, also known as constrictive bronchiolitis or obliterative bronchiolitis, is a rare and irreversible lung disease that can be challenging to diagnose. However, various diagnostic tests can help confirm the condition.

Diagnostic Tests:

  • Chest X-ray: A chest X-ray may show signs of pneumonia or other conditions, but it's not typically used as a primary diagnostic tool for bronchiolitis obliterans.
  • CT scan: A high-resolution CT scan is often used to diagnose bronchiolitis obliterans. It can show characteristic features such as mosaic perfusion, vascular attenuation, and central airway dilatation [8].
  • Viral testing: A swab test from the nose or throat may be performed to identify the virus causing bronchiolitis.
  • Blood tests: Blood tests may be conducted to rule out other conditions that can cause similar symptoms.
  • Surgical lung biopsy: This is considered the most definitive diagnostic method for bronchiolitis obliterans, but it's typically reserved for cases where other tests are inconclusive [9].
  • Pulmonary function tests: These tests can demonstrate airflow obstruction and air trapping, which are characteristic of bronchiolitis obliterans [15].

Other Diagnostic Tools:

  • Six-minute walk test: This test may be used to assess prognosis in lung transplant recipients who have developed bronchiolitis obliterans [5].
  • Clinical history and examination: A thorough clinical evaluation is essential to identify diagnostic features and physical findings.
  • Biopsy reports: Histopathological examination of biopsy samples can provide valuable information for diagnosis.

It's essential to note that a combination of these tests may be necessary to confirm the diagnosis of bronchiolitis obliterans. A healthcare provider will use their professional judgment to determine the most appropriate diagnostic approach based on individual patient needs.

References:

[1] Context 10 [2] Context 11 [3] Context 12 [4] Context 13 [5] Context 5 [6] Context 6 [7] Context 7 [8] Context 8 [9] Context 9 [15] Context 15

Additional Diagnostic Tests

  • Blood tests
  • Chest X-ray
  • Pulmonary function tests
  • CT scan
  • Viral testing
  • Surgical lung biopsy

Treatment

Treatment Options for Bronchiolitis Obliterans

Bronchiol

Recommended Medications

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Differential Diagnosis

Bronchiolitis obliterans (BO) is a rare and serious lung disease that requires prompt diagnosis to initiate effective treatment. The differential diagnosis of BO involves considering various conditions that can present with similar symptoms and radiographic findings.

Conditions to Consider:

  • Asthma: Severe asthma can be radiographically indistinguishable from bronchiolitis obliterans [3][9]. However, asthma typically shows reversible airflow obstruction, whereas BO is characterized by irreversible airflow limitation.
  • Bronchiectasis with secondary air trapping: This condition can present with similar radiographic findings to BO, but it is often associated with chronic infection and inflammation [6].
  • Panlobular emphysema: This type of emphysema can have a lower lung zone predominance and may be mistaken for BO on imaging studies [11].
  • Pulmonary artery hypertension: This condition can cause similar symptoms to BO, including shortness of breath and fatigue.
  • Cryptogenic bronchiolitis obliterans: This is a rare form of BO that must be differentiated from refractory asthma. While most cases of asthma show reversible airflow obstruction, some cases of severe asthma may present with irreversible airflow limitation [13].

Other Conditions to Consider:

  • Diffuse panbronchiolitis: This condition can have overlapping clinical and radiological manifestations with BO.
  • Branchial cleft cyst: This is a rare congenital anomaly that can cause respiratory symptoms and must be considered in the differential diagnosis of BO.

Diagnostic Tools:

  • Transbronchial biopsy: This procedure can aid in the diagnosis of BO, particularly in lung transplant recipients [12][26].
  • Imaging studies: High-resolution computed tomography (HRCT) scans can help differentiate BO from other conditions, but they are not always diagnostic on their own.

It is essential to consider these differential diagnoses when evaluating patients with suspected bronchiolitis obliterans. A thorough clinical evaluation, supported by imaging and biopsy results, can help guide treatment decisions and improve patient outcomes.

Additional Differential Diagnoses

  • childhood-onset asthma
  • Panlobular emphysema
  • Branchial cleft cyst
  • Bronchiectasis with secondary air trapping
  • Pulmonary artery hypertension
  • Cryptogenic bronchiolitis obliterans
  • Diffuse panbronchiolitis
  • asthma

Additional Information

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It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.