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Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients

OBJECTIVE: Aspiration can cause a variety of pulmonary syndromes, some of which are not well recognized. The objective of this study was to assess the demographic, clinical, radiological, and histopathological correlates of diffuse aspiration bronchiolitis (DAB), a bronchiolocentric disorder caused...

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Autores principales: Hu, Xiaowen, Yi, Eunhee Suh, Ryu, Jay Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sociedade Brasileira de Pneumologia e Tisiologia 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428853/
https://www.ncbi.nlm.nih.gov/pubmed/25972969
http://dx.doi.org/10.1590/S1806-37132015000004516
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author Hu, Xiaowen
Yi, Eunhee Suh
Ryu, Jay Hoon
author_facet Hu, Xiaowen
Yi, Eunhee Suh
Ryu, Jay Hoon
author_sort Hu, Xiaowen
collection PubMed
description OBJECTIVE: Aspiration can cause a variety of pulmonary syndromes, some of which are not well recognized. The objective of this study was to assess the demographic, clinical, radiological, and histopathological correlates of diffuse aspiration bronchiolitis (DAB), a bronchiolocentric disorder caused by recurrent aspiration. METHODS: This was a retrospective study of 20 consecutive patients with DAB seen at the Mayo Clinic in Rochester, Minnesota, between January 1, 1998 and June 30, 2014. RESULTS: The median age of the patients was 56.5 years (range, 22-76 years), and the male/female ratio was 2.3:1.0. In 18 patients, the diagnosis of DAB was based on the results of a lung biopsy; in the 2 remaining patients, it was based on clinical and radiological features, together with documented aspiration observed in a videofluoroscopic swallow study. In 19 patients (95%), we identified predisposing factors for aspiration, including gastroesophageal reflux disease (GERD), drug abuse, and dysphagia. Common presenting features included cough, sputum production, dyspnea, and fever. Twelve patients (60%) had a history of recurrent pneumonia. In all of the patients, chest CT revealed bilateral pulmonary infiltrates consisting of micronodules and tree-in-bud opacities. In the majority of patients, interventions aimed at preventing recurrent aspiration (e.g., anti-GERD therapies) led to improvement in the symptoms of DAB. CONCLUSIONS: Young to middle-aged subjects with recognizable predisposing factors for aspiration and who report a history of recurrent pneumonia are at increased risk for DAB. Although DAB is not well recognized, certain chest CT features are characteristic of the disorder.
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spelling pubmed-44288532015-05-13 Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients Hu, Xiaowen Yi, Eunhee Suh Ryu, Jay Hoon J Bras Pneumol Original Article OBJECTIVE: Aspiration can cause a variety of pulmonary syndromes, some of which are not well recognized. The objective of this study was to assess the demographic, clinical, radiological, and histopathological correlates of diffuse aspiration bronchiolitis (DAB), a bronchiolocentric disorder caused by recurrent aspiration. METHODS: This was a retrospective study of 20 consecutive patients with DAB seen at the Mayo Clinic in Rochester, Minnesota, between January 1, 1998 and June 30, 2014. RESULTS: The median age of the patients was 56.5 years (range, 22-76 years), and the male/female ratio was 2.3:1.0. In 18 patients, the diagnosis of DAB was based on the results of a lung biopsy; in the 2 remaining patients, it was based on clinical and radiological features, together with documented aspiration observed in a videofluoroscopic swallow study. In 19 patients (95%), we identified predisposing factors for aspiration, including gastroesophageal reflux disease (GERD), drug abuse, and dysphagia. Common presenting features included cough, sputum production, dyspnea, and fever. Twelve patients (60%) had a history of recurrent pneumonia. In all of the patients, chest CT revealed bilateral pulmonary infiltrates consisting of micronodules and tree-in-bud opacities. In the majority of patients, interventions aimed at preventing recurrent aspiration (e.g., anti-GERD therapies) led to improvement in the symptoms of DAB. CONCLUSIONS: Young to middle-aged subjects with recognizable predisposing factors for aspiration and who report a history of recurrent pneumonia are at increased risk for DAB. Although DAB is not well recognized, certain chest CT features are characteristic of the disorder. Sociedade Brasileira de Pneumologia e Tisiologia 2015 /pmc/articles/PMC4428853/ /pubmed/25972969 http://dx.doi.org/10.1590/S1806-37132015000004516 Text en http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hu, Xiaowen
Yi, Eunhee Suh
Ryu, Jay Hoon
Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
title Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
title_full Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
title_fullStr Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
title_full_unstemmed Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
title_short Diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
title_sort diffuse aspiration bronchiolitis: analysis of 20 consecutive patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428853/
https://www.ncbi.nlm.nih.gov/pubmed/25972969
http://dx.doi.org/10.1590/S1806-37132015000004516
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