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Bronchiolitis obliterans when it occurs following a lung transplant is known as bronchiolitis obliterans syndrome (BOS). [11] [4] BOS is defined as a person who has had either a HSCT or lung transplant and develops symptoms or radiographic findings consistent with bronchiolitis obliterans, but has not been confirmed by biopsy. [22] [44]
The American Thoracic Society and the European Respiratory Society hold that "cryptogenic organizing pneumonia" is the preferred clinical term for this disease for multiple reasons: [6] [7] Avoid confusion with bronchiolitis obliterans, which may not be visualized in every case of this disease. Avoid confusion with constrictive bronchiolitis
The current state of evidence suggests that nebulized epinephrine is not indicated for children with bronchiolitis except as a trial of rescue therapy for severe cases. [ 9 ] [ 20 ] Epinephrine is an α and β adrenergic agonist that is used to treat other upper respiratory tract illnesses, such as croup , as a nebulized solution. [ 51 ]
When addressing obliterative bronchiolitis in a rat tracheal transplant model of fibrous airway obliteration related to transplantation, Keshavjee's research showed that the adenoviral IL-10 gene transfection was able to prevent the development of bronchiolitis obliterans.
Epler was an Associate Clinical Professor at Boston University and has been an Associate Clinical Professor at Harvard Medicinal School since 1998. [4] He was Visiting Professor at Kyoto University School of Medicine in Kyoto, Japan. He was the team pulmonary physician for the Boston Celtics NBA basketball team. [8]
Respiratory bronchiolitis is a lung disease associated with tobacco smoking. [1] In pathology, it is defined by the presence of " smoker's macrophages ". [ 1 ] When manifesting significant clinical symptoms it is referred to as respiratory bronchiolitis interstitial lung disease (RB-ILD).
The clinical syndrome is associated with pathological findings including pneumonia, eosinophilic pneumonia, cryptogenic organizing pneumonia, acute fibrinous organizing pneumonia, and diffuse alveolar damage (DAD). Of these, the pathology most commonly associated with ARDS is DAD, which is characterized by a diffuse inflammation of lung tissue.
Up to one in five infants with bronchiolitis will have adenovirus infection, which can be severe. [2] Bronchiolitis obliterans is uncommon, but can occur if adenovirus causes pneumonia with prolonged fever, and can result in difficulty breathing. [2] It presents with a hyperinflated chest, expiratory wheeze and low oxygen. [2]