The Clinicoradiological Profile of Obliterative Bronchiolitis at a Tertiary Care Centre

Abstract

Background: Obliterative Bronchiolitis (OB) forms a major proportion of chronic airway diseases (CAD). OB is often misdiagnosed and included under the umbrella term Chronic Obstructive Pulmonary Disease (COPD). Hence the above study was done, to identify the proportion of OB cases amongst the CADs and study the clinical profile of OB.

Materials and Methods: This prospective, observational study noted all patients of chronic airflow obstruction (CAO), out of which patients with OB were included and the clinical profile was studied. Data was analysed in percentages and mean.

Results: 500 patients of CAO were noted in the study period out of which 115 patients were found to be OB amounting to a prevalence of 23%. The mean age of presentation was 51.8 years with male female ratio of 1:1. The most common etiology for OB was as a sequelae to past treated pulmonary tuberculosis (PTB) seen in 82 patients (71%) of cases. Dyspnea 114 patients (99%) and productive cough 110 patients (95%) were the predominant symptoms. Post exercise desaturation was seen in all 115 patients (100%). Forty-six patients (43%) patients presented with either type 1 or type 2 respiratory failure. Spirometry showed obstructive pattern in 68 patients (59%) and mixed pattern in 47 patients (41%). There was presence of mosaic attenuation on high resolution computerised tomography (HRCT) Chest with expiratory scans in all 115 patients (100%). Pulmonary hypertension (PH) was documented in 109 patients (95%).

Conclusion: OB is one of the major causes of CAO. HRCT Chest with expiratory scans plays a pivotal role in diagnosis. Early diagnosis can prevent irrevocable complications.