Chest
Selected ReportsRespiratory Bronchiolitis Associated With Severe Dyspnea, Exertional Hypoxemia, and Clubbing
Section snippets
Case 1
A 47-year-old previously well white man with a 25-year history of smoking had been treated at a local hospital for COPD and IPF for 4 years. The diagnosis of IPF was based on a chest radiograph, which showed reticular shadowing in both lung bases. He failed to improve with an empiric trial of steroids and continued to deteriorate to the point where he was unable to carry out his daily activities. Home oxygen therapy was necessary, and he was referred for further evaluation. Medications included
Case 2
A 43-year-old white man with a diagnosis of COPD and 100 pack-year history of tobacco use presented with increasing dyspnea of 2 years’ duration. He worked as a roofer until 2 years prior to presentation, when his symptoms worsened and he had to quit working. His medical history was significant only for an episode of hepatitis A. Medications included albuterol, ipratropium, and salmeterol inhalers. On examination, he had normal vital signs. Extremities revealed early clubbing of fingers.
Discussion
Cigarette smoking is a well-recognized cause of a variety of lung diseases, including COPD/emphysema, lung cancer, and respiratory bronchiolitis. Although interstitial fibrosis is recognized as a part of the histologic response to inhalation of cigarette smoke in both animals and humans,6, 7 the role of smoke inhalation as a cause of clinically significant interstitial lung disease is less well defined.
Respiratory bronchiolitis was first described in the early 1970s and is considered an
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Respiratory bronchiolitis associated interstitial lung disease and its relationship to desquamative interstitial pneumonia
Mayo Clin Proc
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Respiratory bronchiolitis causing interstitial lung disease: a clinico pathologic study of six cases
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Cited by (0)
This work was supported by The US Department of Veterans Affairs; and Grant No. HL 48164 and HL 07123, National Heart, Lung, and Blood Institute, National Institutes of Health.