A Case of Chronic Aspiration Bronchiolitis

Abstract

Chronic aspiration bronchiolitis or diffuse aspiration bronchiolitis is a rare disease characterized by chronic inflammation of the bronchioles due to recurrent aspiration of foreign material. To date, there are limited data on chronic aspiration bronchiolitis because it is often present subclinically or remains undiscovered until autopsy. Additionally, time to diagnosis is often prolonged and includes invasive workup prior to definitive diagnosis. Here, we present a case of lung disease attributed to chronic aspiration after a thorough workup resulted in histopathology consistent with a primary diagnosis of aspiration bronchiolitis. Radiographic and pathologic specimens also demonstrated features of usual interstitial pneumonia adding to the complexity of pathology that can be seen with aspiration diseases.

Diffuse Aspiration Bronchiolitis With Neuromyelitis Optica Spectrum Disorder

“…DAB is common in older individuals with dysphagia associated with neurological disease or dementia. However, DAB has been reported to develop as a complication of esophageal achalasia even in younger individuals [3][4][5][6]. Characteristic signs of NMOSD include dysphagia and hiccups due to brainstem lesions, eye movement disorders, impaired hearing, facial palsy, trigeminal neuropathy, dizziness, and ataxia [7].…”

“…It may occur in patients with underlying conditions that predispose them to aspiration, such as gastroesophageal reflux disease, cerebrovascular disease, and neuromuscular disease. Although occurrences in younger patients have been reported, it can be challenging to suspect the pathogenesis of aspiration in these individuals, which may lead to a delayed diagnosis [ 3 - 5 ]. In this report, we present the case of a young woman with DAB associated with neuromyelitis optica spectrum disorder (NMOSD).…”