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Bronchiolitis obliterans
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Bronchiolitis obliterans

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Contributors: Abhijeet Waghray MD, Mary Anne Morgan MD, Paritosh Prasad MD
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Synopsis

Bronchiolitis obliterans is a condition marked by diffuse lung damage that can affect both infants and adults and immunocompetent and immunocompromised patients. It is characterized by injury to the small airways (bronchioles) resulting in progressive narrowing of bronchial lumens. Causes include inhalation injury (eg, chlorine, ammonia), infection (eg, adenovirus, influenza, parainfluenza, respiratory syncytial virus), medications (eg, rituximab, sulfasalazine), toxic fumes (eg, silos, welders), and graft-versus-host disease following bone marrow or rejection following lung transplantation. Bronchiolitis obliterans may also been seen in the setting of autoimmune diseases like rheumatoid arthritis.

The clinical syndrome manifests as an airway obstruction, cough, and slowly progressive dyspnea (weeks to months), with radiographic examination showing normal or hyperinflation of the lungs. Tachypnea, crackles, and/or wheezing may be evident on physical examination.

Related topic: Bronchiolitis

Codes

ICD10CM:
J42 – Unspecified chronic bronchitis

SNOMEDCT:
40100001 – Obliterative bronchiolitis

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 03/19/2018
Last Updated: 04/18/2018
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Bronchiolitis obliterans
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Bronchiolitis obliterans : Exertional dyspnea, Patchy consolidation, Weight loss, Wheezing, Dry cough, Hypoxia
Imaging Studies image of Bronchiolitis obliterans
Axial 0.90mm slice thickness non-contrast CT image of the chest viewed in lung windows in the upper chest. Axial CT image of the chest demonstrates mosaic attenuation throughout both lungs, with geographic areas of decreased attenuation (straight black arrows) and decreased vascularity (straight white arrow).
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