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About Bronchiolitis Obliterans

Bronchiolitis obliterans is an inflammatory obstruction of the lung's tiniest airways, called bronchioles. The bronchioles become damaged and inflamed, leading to extensive scarring that blocks the airways.

What causes bronchiolitis obliterans?

The disease can be caused by breathing in irritant fumes, such as chlorine, ammonia, oxides of nitrogen or sulfur dioxide. Diacetyl , a chemical used to provide butter flavor in many foods, has also been suspected of causing bronchiolitis obliterans in workers who manufacture it or mix it into foods, such as butter-flavored popcorn. Bronchiolitis obliterans also can result from respiratory infections, a connective tissue disorder such as rheumatoid arthritis, and after a bone marrow, lung or heart-lung transplant.

Another similarly named disease, bronchiolitis obliterans organizing pneumonia, is a completely different disease.

What are the symptoms?

Bronchiolitis obliterans usually presents with a dry cough and shortness of breath, especially on exertion, two to eight weeks after toxic fume exposure or a respiratory illness. It may be several months or years until it presents itself after a transplant.

Fatigue and wheezing in the absence of a cold or asthma are other symptoms of this interstitial lung disease.

How is it diagnosed and treated?

Imaging tests and pulmonary function tests can help detect bronchiolitis obliterans. A lung biopsy, however, is the only definitive way to diagnose the disease.

The disease is irreversible. Treatment, however, can help to stabilize or, at least, slow its progression. For that reason it is important to recognize bronchiolitis obliterans early because intervention in the late stages of the disease may prove ineffective.

Treatment usually involves medication therapy, primarily the use of corticosteroids. In some cases, immunosuppressive therapies, which decrease the body's immune response, and organ transplants are used to treat the disease.

In the case of toxic exposures, immediate removal from the irritating environment is crucial to slowing progression of the disease. 

If left untreated, bronchiolitis obliterans can be fatal. It is the primary cause of death following a lung or heart-lung transplant.

 

This information has been approved by Lisa Maier, M.D. (Septmeber 2007).

Note: This information is provided to you as an educational service of National Jewish Health. It is not meant to be a substitute for consulting with your own physician.

© Copyright 2008 National Jewish Health

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