Demographics of Sporadic Obliterative Bronchiolitis
Obliterative bronchiolitis (OB) is most common after transplantation or exposure to inhaled toxins but can also be idiopathic. A single institution review that also included a review of the literature found 113 total confirmed cases of OB of which 42% were idiopathic, 31% associated with connective tissue diseases, 15% associated with inhalation exposures, and the rest associated with other risk factors, such as polymyositis, pemphigus vulgaris, and lymphoma. Key findings included the following:
- Middle-aged white women were most commonly affected.
- All patients demonstrated expiratory air trapping on a chest CT scan.
- Most patients were treated with corticosteroids (77%), followed by steroid-sparing agents (46%) and macrolides (22%).
- Pulmonary function tests did not change significantly over long-term follow-up (median, ~4.5 years).
- Any-cause mortality incidence was 82/1000 patient-years.
- Eight of the 14 total deaths were due to respiratory failure or complications of immunosuppressive therapy.
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Callahan SJ, Vranic A, Flors L, Hanley M, Stoler MH, Mehrad B. Sporadic obliterative bronchiolitis: case series and systematic review of the literature. Mayo Clin Proc Innov Qual Outcomes. 2019;3(1):86-93. doi:10.1016/j.mayocpiqo.2018.10.003.