J Korean Med Sci.  2015 Jun;30(6):823-828. 10.3346/jkms.2015.30.6.823.

Single Center Experience of Five Diffuse Panbronchiolitis Patients Clinically Presenting as Severe Asthma

• Park KH
• Park HJ
• Lee JH
• Park JW

• KMID: 2160614
• DOI: http://doi.org/10.3346/jkms.2015.30.6.823

Abstract

Diffuse panbronchiolitis (DPB) is a bronchiolitis affecting the whole lung fields which can be treated by macrolide. Especially East Asian patients are more susceptible to diffuse panbronchiolitis. As asthma and DPB both can cause airway obstruction, differential diagnosis is important for the 2 diseases. Here we report 5 patients with DPB clinically presenting as severe asthma in Korea, who were well treated by macrolide. Among the 5 patients, 2 could stop their asthma inhalers and the other 3 could reduce asthma medications after diagnosis and treatment of DPB. In conclusion, considering DPB as differential diagnosis for asthmatics in Asian ethnic groups is important.

Keyword

Diffuse Panbronchiolitis; Asthma; Clarithromycin

MeSH Terms

Adult
Aged
Anti-Asthmatic Agents/*therapeutic use
Asthma/*diagnosis/*drug therapy
Bronchiolitis/*diagnosis/*drug therapy
Diagnosis, Differential
Female
Haemophilus Infections/*diagnosis/*drug therapy
Humans
Macrolides/*administration & dosage
Male
Middle Aged
Severity of Illness Index
Treatment Outcome
Anti-Asthmatic Agents
Macrolides

Figure

• 

  Fig. 1 Images of the Case 1. Initial chest x-ray showed bilateral haziness at bilateral lung field (A) and both maxillary sinusitis (B). Chest CT showed diffuse bronchial wall thickening with centrilobular nodules (C, D).

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  Fig. 2 Images of the Case 3. Bronchiolectasis and centrilobular nodules were observed on almost entire lung in his chest CT (A, B).

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  Fig. 3 Images of the Case 4. Initial CT showed bronchial wall thickening, centrilobular nodules (A, B).

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  Fig. 4 Images of the Case 5. Tiny nodules, bronchial wall thickening (A) and left maxillary sinusitis (B) were observed. Initial CT showed severe and diffuse centrilobular nodules (C). After treatment, multiple nodules were decreased (D).

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