Clinical Comprehensive Analysis of Diffuse Panbronchiolitis_West China Medical Journal

Authors：

 WANGRong-chun , HEChen-yun , LUOJian ,  LIANGZong-an

Department of Respiratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LIANGZong-an, Email: liangzongan@hotmail.com

Keywords：

Diffuse panbronchiolitis; Macrolides; Clinical characteristics

DOI：

10.7507/1002-0179.20140612

Video：

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Objective To enhance the cognition about the clinical characteristics of diffuse panbronchiolitis (DPB). Methods The data of patients with DPB searched out on the computer from January 1996 to September 2013 were retrospectively studied. Results The 91 patients had a male to female ratio of 2︰1, and the mean age at onset was (40.5± 18.4) years old. The median course of disease was 7 years. The main clinical profiles included chronic cough, sputum production, exertional dyspnea, and crackles. A history of sinusitis occurred in 90.1% (82/91) of the patients. Positive rate of cold hemoagglutinin and HLA-B54 were 46.1% (30/65) and 42.1% (8/19), respectively. All patients' CT scans showed bilateral, diffuse, small centrilobular nodules. Lung function assessment showed an obstructive ventilation disfunction in 60.0% (51/85) of the patients and a mixed obstructive-restrictive pattern in 36.5% (31/85) of the patients. Thirty-four patients underwent lung biopsy. A total of 65.9% (60/91) of the patients had been misdiagnosed, and 98.8% (84/85) of the patients achieved significant improvement after the macrolide therapy. Conclusion DPB is not rare in China, but tends to be misdiagnosed or underdiagnosed. Macrolides can improve the prognosis of DPB.

Citation： WANGRong-chun, HEChen-yun, LUOJian, LIANGZong-an. Clinical Comprehensive Analysis of Diffuse Panbronchiolitis. West China Medical Journal, 2014, 29(11): 2019-2022. doi: 10.7507/1002-0179.20140612 Copy

1.	Yamanaka A, Saiki S, Tamura S, et al. Problems in chronic obstructive bronchial diseases, with special reference to diffuse panbronchiolitis[J]. Naika, 1969, 23(3):442-451.
2.	Sugiyama Y. Diffuse panbronchiolitis[J]. Clin Chest Med, 1993, 14(4):765-772.
3.	Kudoh S, Uetake T, Hagiwara K, et al. Clinical effects of low-dose long-term erythromycin chemotherapy on diffuse panbronchiolitis[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1987, 25(6):632-642.
4.	Kudoh S, Azuma A, Yamamoto M, et al. Improvement of survival in patients with diffuse panbronchiolitis treated with low-dose erythromycin[J]. Am J Respir Crit Care Med, 1998, 157(6 Pt 1):1829-1832.
5.	Li H, Zhou Y, Fan F, et al. Effect of azithromycin on patients with diffuse panbronchiolitis:retrospective study of 51 cases[J]. Intern Med, 2011, 50(16):1663-1669.
6.	Izumi T, Doi O, Nobechi A, et al. Nation-wide survey of diffuse panbronchiolitis[R]. Tokyo:Ministry of Health and Welfare of Japan, 1982:3-41.
7.	劉又寧, 胡紅, 蔡祖龍. 彌漫性泛細支氣管炎一例[J]. 中華結核和呼吸雜志, 1996, 19(2):55-56.
8.	王厚東, 孫鐵英, 李燕明. 彌漫性泛細支氣管炎一例[J]. 中華結核和呼吸雜志, 1996, 19(2):56, 69.
9.	Nakata K. Revision of clinical guidelines for diffuse panbronchiolitis[R]. Tokyo:Ministry of Health and Welfare of Japan, 1998:109-111.
10.	Aslan AT, Ozcelik U, Talim B, et al. Childhood diffuse panbronchiolitis:a case report[J]. Pediatr Pulmonol, 2005, 40(4):354-357.
11.	李惠萍. 關于病理活檢在彌漫性泛細支氣管炎診斷中地位的個人見解[J]. 中華結核和呼吸雜志, 2009, 32(3):234.
12.	Sugiyama Y, Kudoh S, Maeda H, et al. Analysis of HLA antigens in patients with diffuse panbronchiolitis[J]. Am Rev Respir Dis, 1990, 141(6):1459-1462.
13.	Park MH, Kim YW, Yoon HI, et al. Association of HLA class Ⅰantigens with diffuse panbronchiolitis in Korean patients[J]. Am J Respir Crit Care Med, 1999, 159(2):526-529.
14.	Chen Y, Kang J, Wu M, et al. Differential association between HLA and diffuse panbronchiolitis in Northern and Southern Chinese[J]. Intern Med, 2012, 51(3):271-276.
15.	Chijimatsu Y, Nakazato Y, Homma H, et al. A case report of good syndrome complicated by diffuse panbronchiolitis[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1982, 20(7):803-808.
16.	Okano A, Sato A, Suda T, et al. A case of diffuse panbronchiolitis complicated by malignant thymoma and Sj?gren's syndrome[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1991, 29(2):263-268.
17.	Mimura T, Yoshimura K, Nakamori Y, et al. Non-Hodgkin lymphoma associated with diffuse panbronchiolitis[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1987, 25(11):1211-1218.

1. Yamanaka A, Saiki S, Tamura S, et al. Problems in chronic obstructive bronchial diseases, with special reference to diffuse panbronchiolitis[J]. Naika, 1969, 23(3):442-451.
2. Sugiyama Y. Diffuse panbronchiolitis[J]. Clin Chest Med, 1993, 14(4):765-772.
3. Kudoh S, Uetake T, Hagiwara K, et al. Clinical effects of low-dose long-term erythromycin chemotherapy on diffuse panbronchiolitis[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1987, 25(6):632-642.
4. Kudoh S, Azuma A, Yamamoto M, et al. Improvement of survival in patients with diffuse panbronchiolitis treated with low-dose erythromycin[J]. Am J Respir Crit Care Med, 1998, 157(6 Pt 1):1829-1832.
5. Li H, Zhou Y, Fan F, et al. Effect of azithromycin on patients with diffuse panbronchiolitis:retrospective study of 51 cases[J]. Intern Med, 2011, 50(16):1663-1669.
6. Izumi T, Doi O, Nobechi A, et al. Nation-wide survey of diffuse panbronchiolitis[R]. Tokyo:Ministry of Health and Welfare of Japan, 1982:3-41.
7. 劉又寧, 胡紅, 蔡祖龍. 彌漫性泛細支氣管炎一例[J]. 中華結核和呼吸雜志, 1996, 19(2):55-56.
8. 王厚東, 孫鐵英, 李燕明. 彌漫性泛細支氣管炎一例[J]. 中華結核和呼吸雜志, 1996, 19(2):56, 69.
9. Nakata K. Revision of clinical guidelines for diffuse panbronchiolitis[R]. Tokyo:Ministry of Health and Welfare of Japan, 1998:109-111.
10. Aslan AT, Ozcelik U, Talim B, et al. Childhood diffuse panbronchiolitis:a case report[J]. Pediatr Pulmonol, 2005, 40(4):354-357.
11. 李惠萍. 關于病理活檢在彌漫性泛細支氣管炎診斷中地位的個人見解[J]. 中華結核和呼吸雜志, 2009, 32(3):234.
12. Sugiyama Y, Kudoh S, Maeda H, et al. Analysis of HLA antigens in patients with diffuse panbronchiolitis[J]. Am Rev Respir Dis, 1990, 141(6):1459-1462.
13. Park MH, Kim YW, Yoon HI, et al. Association of HLA class Ⅰantigens with diffuse panbronchiolitis in Korean patients[J]. Am J Respir Crit Care Med, 1999, 159(2):526-529.
14. Chen Y, Kang J, Wu M, et al. Differential association between HLA and diffuse panbronchiolitis in Northern and Southern Chinese[J]. Intern Med, 2012, 51(3):271-276.
15. Chijimatsu Y, Nakazato Y, Homma H, et al. A case report of good syndrome complicated by diffuse panbronchiolitis[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1982, 20(7):803-808.
16. Okano A, Sato A, Suda T, et al. A case of diffuse panbronchiolitis complicated by malignant thymoma and Sj?gren's syndrome[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1991, 29(2):263-268.
17. Mimura T, Yoshimura K, Nakamori Y, et al. Non-Hodgkin lymphoma associated with diffuse panbronchiolitis[J]. Nihon Kyobu Shikkan Gakkai Zasshi, 1987, 25(11):1211-1218.

West China Medical Journal

Clinical Comprehensive Analysis of Diffuse Panbronchiolitis

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