Obliterative Bronchiolitis

What is Obliterative Bronchiolitis

Obliterative bronchiolitis is a rare lung disease that causes the small airways of the lungs (bronchioles) to harden and scar. It often affects people who are regularly exposed to fumes that irritate the lungs.

As the disease progresses, it causes a cough and shortness of breath that gets worse over time. Eventually, this disease may make it hard for the person to breathe.

What are the causes?

This condition may be caused by:

  • Exposure to toxic fumes from:
    • Chlorine.
    • Ammonia.
    • Nitrogen oxide.
    • Sulfur dioxide.
    • Diacetyl. This is a chemical that is used in making microwave popcorn.
  • Bone marrow, lung, or heart-lung transplants.
  • Viruses that infect the lungs.
  • Connective tissue disorders, such as rheumatoid arthritis or lupus.
  • Lung conditions that produce hormones. These include certain tumors of the lungs.
  • Reaction to medicines.
  • High levels of air pollution.
  • Long-lasting heartburn (chronic esophageal reflux).

Sometimes the cause of obliterative bronchiolitis is not known (idiopathic).

What increases the risk?

You may have a higher risk of this condition if you are exposed to toxic fumes. Fumes may come from:

  • Production of fertilizer, microwave popcorn, or fiberglass.
  • Coffee roasting.
  • Smoke from uncontrolled fire.
  • Chemical weapons used during warfare.

What are the signs or symptoms?

Symptoms of this condition may get worse over time. These include:

  • Shortness of breath.
  • Dry cough.
  • Wheezing.
  • Fever.
  • Night sweats.
  • Weight loss.

How is this diagnosed?

Your health care provider may suspect the condition from your signs and symptoms, especially if you have a history of exposure to toxic fumes. He or she may also do:

  • A physical exam.
  • A biopsy. In this test, a small sample of lung tissue is removed and examined under a microscope. This is the only sure way to diagnose this condition.

You may also have tests to check lung function. These may include:

  • Breathing (pulmonary function) tests.
  • Chest X-ray.
  • CT scan.

How is this treated?

There is no cure for obliterative bronchiolitis. Treatment aims to improve your symptoms, help you breathe better, and prevent additional damage. You may need lung transplant surgery if you have a severe case of this condition. Other possible treatments include:

  • Nutrition therapy to gain weight, if you are underweight.
  • Pulmonary rehabilitation. This may involve working with a team of specialists to strengthen your lungs.
  • Medicines. This may include:
    • Bronchodilators to open airways.
    • Inhaled steroids to decrease lung inflammation.
    • Oxygen to support breathing.
    • Medicines that suppress your body’s defense system (immune system).

Follow these instructions at home:

Medicines

  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep your vaccines current as directed by your health care provider.

General instructions

  • Do exercise as recommended by your health care provider.
  • Drink enough fluid to keep your urine pale yellow.
  • Use oxygen therapy and pulmonary rehabilitation as directed by your health care provider.
  • Do not use any products that contain nicotine or tobacco, such as cigarettes and e-cigarettes. If you need help quitting, ask your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if you:

  • Have a fever.
  • Have shortness of breath that is getting worse.
  • Are unable to maintain your weight.
  • Are unable to quit smoking.

Get help right away if you:

  • Are struggling to breathe.
  • Have chest pain.

Summary

  • Obliterative bronchiolitis is a rare lung disease that causes the small airways of the lungs to harden and scar. It often affects people who are regularly exposed to fumes that irritate the lungs.
  • There is no cure for obliterative bronchiolitis. Treatment aims to improve your symptoms, help you breathe better, and prevent additional damage.
  • Treatment for obliterative bronchiolitis may include medicines and pulmonary rehabilitation. In severe cases, a lung transplant may be needed.
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