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| {{Infobox_Disease | | | {{Infobox_Disease | |
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| {{SI}} | | {{Bronchiolitis obliterans}} |
| '''Editor-in-Chief:''' Kaochoy Saechao, MD, MPH
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| | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
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| | {{CMG}},;{{AE}}{{HM}} |
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| ==Overview==
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| '''Bronchiolitis obliterans''', '''Popcorn Workers' Lung''' or '''Diacetyl-induced Bronchiolitis Obliterans - DiBO''', is a rare disease of the lung wherein the bronchioles are obliterated with fibrotic tissue. | | {{SK}} Obliterative bronchiolitis; proliferative bronchiolitis; bronchiolitides; popcorn lung; popcorn lung disease; popcorn workers' lung; diacetyl-induced bronchiolitis obliterans |
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| ==Etiology== | | ==[[Bronchiolitis obliterans overview|Overview]]== |
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| Bronchiolitis obliterans has many possible causes, including: [[collagen vascular disease]], [[transplant rejection]] in [[organ transplant]] patients, viral infection ([[RSV]], [[adenovirus]], [[Pneumocystis pneumonia|PCP]], [[HIV]], [[CMV]]), drug reaction, aspiration and complications of prematurity ([[bronchopulmonary dysplasia]]), and exposure to toxic fumes, including: [[diacetyl]], [[sulfur dioxide]], [[nitrogen dioxide]], [[ammonia]], [[chlorine]], [[thionyl chloride]], [[methyl isocyanate]], [[hydrogen fluoride]], [[hydrogen bromide]], [[hydrogen chloride]], [[hydrogen sulfide]], [[phosgene]], polyamide-amine dyes, and [[ozone]]. Additionally, the disorder may be [[idiopathic]] (without known cause). {{ref label|Brant|1|^}}{{ref label|Webb|2|^}}{{ref label|Hazmap|5|^}} | | ==[[Bronchiolitis obliterans historical perspective|Historical Perspective]]== |
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| ==Presentation== | | ==[[Bronchiolitis obliterans classification|Classification]]== |
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| Bronchiolitis obliterans is a lung disease characterized by a fixed airway obstruction. [[Inflammation]] and [[scarring]] occur in the airways of the lung, resulting in shortness of breath and dry cough. | | ==[[Bronchiolitis obliterans pathophysiology|Pathophysiology]]== |
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| ==Diagnosis== | | ==[[Bronchiolitis obliterans causes|Causes]]== |
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| Bronchiolitis obliterans patients should be seen by a board-certified Pulmonologist for accurate diagnosis. | | ==[[Bronchiolitis obliterans differential diagnosis|Differentiating Bronchiolitis obliterans from other Diseases]]== |
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| ==Prognosis/treatment== | | ==[[Bronchiolitis obliterans epidemiology and demographics|Epidemiology and Demographics]]== |
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| This disease is irreversible and severe cases often require a [[lung transplant]]. Evaluation of interventions to prevent bronchiolitis obliterans relies on early detection of abnormal [[spirometry]] results or unusual decreases in repeated measurements.
| | ==[[Bronchiolitis obliterans risk factors|Risk Factors]]== |
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| ==Industrial inhalants== | | ==[[Bronchiolitis obliterans screening|Screening]]== |
| There is no consensus classification scheme for bronchiolitis subtypes. One author describes four specific subtypes as follows: cellular bronchiolitis, respiratory bronchiolitis, bronchiolitis obliterans and bronchiolitis obliterans with intraluminal polyps (proliferative bronchiolitis obliterans). There are many industrial inhalants that are known to cause bronchiolitis. {{ref label|Colby|5|^}}
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| Industrial workers who have presented with bronchiolitis:
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| *nylon-flock workers {{ref label|Hazmap|6|^}}
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| *workers who spray prints onto textiles with polyamide-amine dyes {{ref label|Hazmap|6|^}}
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| *battery workers who are exposed to thionyl chloride fumes
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| *workers at plants that use or manufacture flavorings, e.g. diacetyl butter-like flavoring {{ref label|CDC|3|^}}{{ref label|Hazmap|6|^}}{{ref label|CalOSH|7|^}}
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| | ==[[Bronchiolitis obliterans natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| | ==Diagnosis== |
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| ==See also==
| | [[Bronchiolitis obliterans diagnostic criteria|Diagnostic Criteria]] | [[Bronchiolitis obliterans history and symptoms|History and Symptoms]] | [[Bronchiolitis obliterans physical examination|Physical Examination]] | [[Bronchiolitis obliterans laboratory findings|Laboratory Findings]] | [[Bronchiolitis obliterans chest x ray|Chest X ray]] | [[Bronchiolitis obliterans CT|CT]] | [[Bronchiolitis obliterans MRI|MRI]] | [[Bronchiolitis obliterans other imaging findings|Other Imaging Findings]] | [[Bronchiolitis obliterans other diagnostic studies|Other Diagnostic Studies]] |
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| * [[Diacetyl]]
| | ==Treatment== |
| * [[Bronchiolitis obliterans organizing pneumonia]]
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| ==External links==
| | [[Bronchiolitis obliterans medical therapy|Medical Therapy]] | [[Bronchiolitis obliterans surgery|Surgery]] | [[Bronchiolitis obliterans primary prevention|Primary Prevention]] | [[Bronchiolitis obliterans secondary prevention|Secondary Prevention]] | [[Bronchiolitis obliterans cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Bronchiolitis obliterans future or investigational therapies|Future or Investigational Therapies]] |
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| | ==Case Studies== |
| | [[Bronchiolitis obliterans case study one|Case #1]] |
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| * National Institutes of Health: Haz-Map Information on Hazardous Chemicals and Occupational Diseases by Jay A. Brown, M.D., M.P.H. [http://hazmap.nlm.nih.gov/cgi-bin/hazmap_generic?tbl=TblDiseases&id=551 Bronchiolitis obliterans]
| | ==Related Chapters== |
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| * National Institute for Occupational Safety and Health (NIOSH) Alert: [http://www.cdc.gov/niosh/docs/2004-110/ Preventing lung disease in workers who make or use flavorings]
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| ==Sources== | |
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| * Brant & Helms. ''Fundamentals of Diagnostic Radiology'' LWW, 1999.
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| * Webb, et al. ''High Resolution CT of the Lung''. 3rd edition. LWW, 2000.
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| * Harber, Philip; Saechao, Kaochoy; & Boomus, Catherine. ''Diacetyl-induced lung '' Toxicological Reviews 2006;vol 25(4):261-72.
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| ==References==
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| #{{note label|Brant|1|^}}{{cite book | author=Brant & Helms| title=Fundamentals of Diagnostic Radiology | year=1999 | }}
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| #{{note label|Webb|2|^}}{{cite book | author=Webb, et al| title=High Resolution CT of the Lung | edition=3rd Edition | year=2000 | }}
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| #{{note label|CDC|3|^}}{{cite book | author=Center for Disease Control| title=Fixed obstructive lung disease in workers at a microwave popcorn factory | edition=7th Edition | year=2002 | }}
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| #{{note label|NIOSH|4|^}}National Institute for Occupational Safety and Health. [http://www.cdc.gov/niosh/docs/2004-110/ Preventing lung disease in workers who make or use flavorings, 2004]
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| #{{note label|Colby|5|^}} Colby, T.V. "Bronchiolitis, Pathologic Considerations". ''Am J Clin Pathology'' 1998;109:101-9
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| #{{note label|Hazmap|6|^}}National Institutes of Health. [http://hazmap.nlm.nih.gov/cgi-bin/hazmap_generic?tbl=TblDiseases&id=551 Haz-Map; Information on Hazardous Chemicals and Occupational Diseases by Jay A. Brown, M.D., M.P.H.]
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| #{{note label|CalOSH|7|^}}[http://www.dhs.ca.gov/ohb/flavoringcases.pdf/ California Department of Health Services]
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| #{{note label|NEJM|8|^}}E. Neil Schachter. "Popcorn Workers' Lung". ''New England Journal of Medicine'' 2002;347(5):360-1.
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| #{{note label|Egilman|9|^}}David Egilman (2007). [http://www.ijoeh.com/pfds/IJOEH_1301_Egilman.pdf "Popcorn Workers Lung"]
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| #{{note label|Yahoo|10|^}} [http://news.yahoo.com/s/ap/20070905/ap_on_he_me/popcorn_lung_consumer;_ylt=Apuf6TQn0o.P4GubPgYwzKGs0NUE "Doctor warns consumers of popcorn fumes"], Marcus Kabel, Associated Press, September 5, 2007, hosted by Yahoo! News, retrieved 2007-09-10.
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| #{{note label|letter|11|^}} [http://www.defendingscience.org/case_studies/upload/National_Jewish_FDA_Letter.pdf Letter from Cecile Rose to U.S. Food and Drug Administration], from ''www.defendingscience.org''
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| #{{note label|PH|12|^}} David Michaels (2007). [http://thepumphandle.wordpress.com/2007/09/04/popcorn-lung-coming-to-your-kitchen-the-fda-doesnt-want-to-know/ Popcorn Lung Coming to Your Kitchen? The FDA Doesn’t Want to Know], a blog post at ''thepumphandle.wordpress.com''
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| #{{note label|Reuters|13|^}}Reuters New Report: [http://uk.reuters.com/article/healthNews/idUKN0524254120070905 FDA to probe popcorn link in man's lung disease].
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| #{{note label|Weaver|14|^}} Weaver Popcorn Company Press Release: [http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/08-28-2007/0004652723&EDATE= "Pop Weaver Introduces First Microwave Popcorn With Flavoring Containing No Diacetyl"], 2007-08-27, hosted at PRNewswire.com. {{PDFlink|[http://www.popweaver.com/NoDiacetylPressRelease.pdf "Pop Weaver introduces first microwave popcorn with flavoring containing no diacetyl"]}}.
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| #{{note label|ConAgra|15|^}} USA Today. [http://www.usatoday.com/money/industries/food/2007-09-05-popcorn-lung_N.htm ConAgra to drop popcorn chemical linked to lung ailment]
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| | * [[Diacetyl]] |
| | * [[Bronchiolitis obliterans organizing pneumonia]] |
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| [[Category:Pulmonology]] | | [[Category:Pulmonology]] |
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| [[Category:Occupational safety and health| ]] | | [[Category:Occupational safety and health| ]] |
| [[Category:Industrial hygiene]] | | [[Category:Industrial hygiene]] |
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| [[de:Bronchiolitis obliterans]]
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