Chronic bronchitis overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:
Overview
Bronchitis is an inflammation of the bronchi (medium-size airways) in the lungs. Acute bronchitis is usually caused by viruses or bacteria and may last several days or weeks. Chronic bronchitis is not necessarily caused by infection and is generally part of a syndrome called chronic obstructive pulmonary disease (COPD); it is defined clinically as a persistent cough that produces sputum (phlegm) and mucus, for at least three months in two consecutive years.
Historical Perspective
- Bronchitis was first described by Charles Badham in 1808. Rene Laennec, described COPD in details and categorized it as emphysema and chronic bronchitis[1][2].
Pathophysiology
- Hyperplasia and hypertrophy of the goblet cells (mucous gland) of the airway are the common pathologic features of chronic bronchitis. Chronic inflammation due to lymphocyte infiltration seen on microscopy[3].
- On microscopic histopathological analysis there is infiltration of the airway walls with inflammatory cells, particularly CD8+ T-lymphocytes and neutrophils[4].
- Inflammation is followed by scarring and remodeling that thickens the walls resulting in narrowing of the small airways
Causes
- Chronic bronchitis as a subtype of COPD is caused by multiple environmental and genetic factors. Smoking is the leading cause of chronic bronchitis. Other causes include: air pollutants, occupational exposures to dusts and coal and auto-immune diseases[5][6][7][8].
Differentiating Chronic bronchitis from other Diseases
Chronic bronchitis must be differentiated from other causes of chronic cough and dyspnea which include:congestive heart failure, chronic asthma, bronchiectasis, and bronchiolitis obliterans[9][10].
Epidemiology and Demographics
- COPD occurs in 34 out of 1000 greater than 65 years old[11] or possibly approximately 25 million people if undiagnosed cases are included.[12].
- COPD is the third cause of death in the U.S[13].
- Hispanics were less likely to report COPD than non-Hispanic whites and blacks (4.0% compared with 6.3% and 6.1%, respectively)[14].
- Chronic bronchitis mortality rates are higher among whites than among blacks or persons of all other races.
- Women were more likely to report COPD than men (6.7% compared with 5.2%)[14][15].
- Age adjusted death rates of men has decreased between 1999 till 2014 but this rate was stable among women.
Risk Factors
Common risk factors in the development of chronic bronchitis include cigarette smoking, air pollution, genetic factors, increasing age, male gender, allergy, and repeated airway infections[16][17][18][17][19].
Screening
Natural History, Complications, and Prognosis
Diagnosis
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
CT
Ultrasound
Other Imaging Studies
Other Diagnostic Studies
Treatment
Medical Therapy
Primary Prevention
Secondary Prevention
References
- ↑ terms(2016)https://lunginstitute.com/blog/history-of-chronic-bronchitis/accessed on September,13 2016
- ↑ Klippe HJ, Kirsten D (2009). "[200 years of bronchitis--from 1808 to 2008]". Pneumologie (in German). 63 (4): 228–30. doi:10.1055/s-0028-1119572. PMID 19343614.
- ↑ Hogg JC (2004). "Pathophysiology of airflow limitation in chronic obstructive pulmonary disease". Lancet. 364 (9435): 709–21. doi:10.1016/S0140-6736(04)16900-6. PMID 15325838.
- ↑ Baraldo S, Turato G, Badin C, Bazzan E, Beghé B, Zuin R, Calabrese F, Casoni G, Maestrelli P, Papi A, Fabbri LM, Saetta M (2004). "Neutrophilic infiltration within the airway smooth muscle in patients with COPD". Thorax. 59 (4): 308–12. PMC 1763819. PMID 15047950.
- ↑ MedicineNet.com - COPD causes
- ↑ Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD (2009). "COPD prevalence is increased in lung cancer, independent of age, sex and smoking history". Eur. Respir. J. 34 (2): 380–6. doi:10.1183/09031936.00144208. PMID 19196816. Unknown parameter
|month=ignored (help) - ↑ Devereux, Graham (2006). "Definition, epidemiology, and risk factors". BMJ. 332 (7550): 1142–4. doi:10.1136/bmj.332.7550.1142. PMC 1459603. PMID 16690673. Unknown parameter
|month=ignored (help) - ↑ Kennedy SM, Chambers R, Du W, Dimich-Ward H (2007). "Environmental and occupational exposures: do they affect chronic obstructive pulmonary disease differently in women and men?". Proceedings of the American Thoracic Society. 4 (8): 692–4. doi:10.1513/pats.200707-094SD. PMID 18073405. Unknown parameter
|month=ignored (help) - ↑ Busse WW (2011). "Asthma diagnosis and treatment: filling in the information gaps". J. Allergy Clin. Immunol. 128 (4): 740–50. doi:10.1016/j.jaci.2011.08.014. PMID 21875745.
- ↑ Prina E, Ranzani OT, Torres A (2015). "Community-acquired pneumonia". Lancet. 386 (9998): 1097–108. doi:10.1016/S0140-6736(15)60733-4. PMID 26277247.
- ↑ wrongdiagnosis.com > Prevalence and Incidence of COPD Retrieved on Mars 14, 2010
- ↑ MORBIDITY & MORTALITY: 2009 CHART BOOK ON CARDIOVASCULAR, LUNG, AND BLOOD DISEASES National Heart, Lung, and Blood Institute
- ↑ Kenneth D. Kochanek, M.A.; Jiaquan Xu, M.D.; Sherry L. Murphy, B.S.; Arialdi M. Minin˜o, M.P.H.; and Hsiang-Ching Kung, Ph.D., Division of Vital Statistics, Deaths: Final Data for 2009, 2011, 60,National Vital Statistics Reports, http://www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_03.pdf
- ↑ 14.0 14.1 Morbidity and Mortality Weekly Report (MMWR).(2011).https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6146a2.htm Accessed on September 19,2016
- ↑ Hogg JC, Chu F, Utokaparch S, Woods R, Elliott WM, Buzatu L, Cherniack RM, Rogers RM, Sciurba FC, Coxson HO, Paré PD (2004). "The nature of small-airway obstruction in chronic obstructive pulmonary disease". N. Engl. J. Med. 350 (26): 2645–53. doi:10.1056/NEJMoa032158. PMID 15215480.
- ↑ PIERCE JA, HOCOTT JB, EBERT RV (1961). "The collagen and elastin content of the lung in emphysema". Ann. Intern. Med. 55: 210–22. PMID 13735539.
- ↑ 17.0 17.1 Raherison C, Girodet PO (2009). "Epidemiology of COPD". Eur Respir Rev. 18 (114): 213–21. doi:10.1183/09059180.00003609. PMID 20956146.
- ↑ Mehta GR, Mohammed R, Sarfraz S, Khan T, Ahmed K, Villareal M, Martinez D, Iskander J, Mohammed R (2016). "Chronic obstructive pulmonary disease: A guide for the primary care physician". Dis Mon. 62 (6): 164–87. doi:10.1016/j.disamonth.2016.03.002. PMID 27087562.
- ↑ Jeffery PK (2000). "Comparison of the structural and inflammatory features of COPD and asthma. Giles F. Filley Lecture". Chest. 117 (5 Suppl 1): 251S–60S. PMID 10843939.