A Case Report of a Double-Blind, Randomized Trial of Inhaled Steroids in a Patient with Lung Transplant Bronchiolitis Obliterans

Speich, Rudolf; Boehler, Annette; Russi, Erich W.; Weder, Walter

doi:10.1159/000196708

Cited by 33 publications

(15 citation statements)

References 9 publications

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“…In contrast, corticosteroids or immunosuppressants, rather than macrolide, may be beneficial to patients with OB [21,22,23,24]. However, Gerhardt et al [25] have recently reported the efficacy of oral maintenance therapy with azithromycin for OB.…”

Section: Discussionmentioning

confidence: 99%

Comparative Clinicopathology of Obliterative Bronchiolitis and Diffuse Panbronchiolitis

Homma

Sakamoto²,

Kawabata³

et al. 2006

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Background: The progressive airway obliteration caused by obliterative bronchiolitis (OB) has been widely noted in the world. In contrast, the obstructive respiratory disorder caused by diffuse panbronchiolitis (DPB) has been reported mainly from Japan. Therefore, there might be a considerable overlap between OB and DPB in Japan. Objectives and Methods: To clarify the clinicopathological similarities as well as the differences between OB and DPB, 15 patients with OB and 6 patients with DPB were evaluated clinicopathologically. Results: The underlying disorders in OB were graft-versus-host disease (GVHD) in 7, rheumatoid arthritis in 3, Kartagener’s syndrome in 2, and polymyositis/dermatomyositis, non-tuberculous mycobacterial disease and mycoplasmal pneumonia in one each. The lung pathology demonstrated that the primary obstructive lesions were in the membranous bronchioli in OB. In contrast, they were confined to the respiratory bronchioli in DPB. In addition, OB was classified into two major morphologic types, namely, constrictive and cellular. Clinical manifestations included cough and/or dyspnea in 13 with OB and in 6 with DPB, chronic parasinusitis in 3 with cellular OB and in 6 with DPB. The pulmonary function tests revealed obstructive impairments in all patients with OB and DPB. The chest CT images showed small centrilobular nodules in 64% of those with OB and in all with DPB. The prognosis of constrictive OB was worse than that of cellular OB and DPB. Conclusions: This study demonstrated that histopathologically marked differences existed between OB and DPB, although striking similarities in clinical manifestations were also noted in both diseases.

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Section: Discussionmentioning

confidence: 99%

Comparative Clinicopathology of Obliterative Bronchiolitis and Diffuse Panbronchiolitis

Homma

Sakamoto²,

Kawabata³

et al. 2006

Respiration

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“…There are very few reports on the addition of inhaled corticosteroids to the standard immunosuppressive regimen in the management of BO following lung transplantation [88][89][90][91][92]. These reports do not show clinically significant benefit in the prevention or treatment of BO.…”

Section: Managementmentioning

confidence: 99%

Bronchiolitis obliterans following haematopoietic stem cell transplantation

Soubani

Uberti²

2007

Eur Respir J

111

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The aim of the present article is to review the available clinical data on bronchiolitis obliterans following haematopoietic stem cell transplantation (HSCT).The data sources used were the Medline database and references from the identified articles related to bronchiolitis obliterans, noninfectious pulmonary complications and HSCT.HSCT is an important treatment for a variety of malignant and nonmalignant conditions. However, the procedure is limited by significant complications that may involve every organ of the body. Pulmonary complications are seen in 40-60% of HSCT recipients. The recent advances in prophylaxis and treatment of infectious complications have increased the significance of late noninfectious pulmonary conditions.Currently, bronchiolitis obliterans is one of the most challenging pulmonary complications facing clinicians who are taking care of haematopoietic stem cell transplantation recipients. This article reviews the clinical and pathological features of this condition, sheds some light on potential mechanisms of pathogenesis, and discusses the available management options.

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“…Treatment of patients with BO/BOS rarely reverses the lung dysfunction. Several therapies have been attempted; a few have resulted in stabilization of the patient's pulmonary status but treatment is generally disappointing [3,4,6,8,9,14,[16][17][18][19]22]. However, even when attempts are made to reverse or stabilize the patient's pulmonary status, progression of the chronic rejection process frequently occurs.…”

mentioning

confidence: 99%

Laparoscopic antireflux surgery in the lung transplant population

et al. 2002

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GERD occurs commonly in the posttransplant lung population. Laparoscopic fundoplication surgery, when indicated, can be done safely with minimal morbidity and mortality. In addition to the resolution of reflux symptoms, improvement in pulmonary function may be seen in this population after fundoplication. Lung transplant patients with severe GERD should be strongly considered for antireflux surgery.

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A Case Report of a Double-Blind, Randomized Trial of Inhaled Steroids in a Patient with Lung Transplant Bronchiolitis Obliterans

Cited by 33 publications

References 9 publications

Comparative Clinicopathology of Obliterative Bronchiolitis and Diffuse Panbronchiolitis

Comparative Clinicopathology of Obliterative Bronchiolitis and Diffuse Panbronchiolitis

Bronchiolitis obliterans following haematopoietic stem cell transplantation

Laparoscopic antireflux surgery in the lung transplant population

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