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Constrictive Bronchiolitis Attributable to Inhalation of Toxic Agents: Considerations for a Case Definition.

Banks, Daniel E. MD, MS; Bolduc, Caroline A. MD; Ali, Sayed MD; Morris, Michael J. MD
Journal of Occupational & Environmental Medicine: Post Acceptance: September 25, 2017
doi: 10.1097/JOM.0000000000001176
Original Article: PDF Only

Objective: We identified cases of Constrictive Bronchiolitis (CB), an inflammatory injury obliterating the small airways, in adults caused by inhalational exposure to determine an appropriate case definition.

Methods: We performed a systematic review with meta-analysis for these cases from 1990 to 2017. Publications were included if there was 1) inhalational exposure; 2) respiratory symptoms/signs; 3) pulmonary function test results; and 4) computerized tomographic chest imaging. Many had a lung biopsy.

RESULTS: 274 articles were retrieved; 22 manuscripts comprising 102 cases were included. Diagnostic criteria from cases associated with military deployment to southwest Asia were statistically different from criteria of other etiologies.

Conclusions: In three cases the scan was consistent with CB, the biopsy non-diagnostic, yet the diagnosis was made. CB associated with military deployment presented with diagnostic features statistically different from features in the other cases.

Copyright (C) 2017 by the American College of Occupational and Environmental Medicine