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Respiratory bronchiolitis associated with interstitial lung disease
Last reviewed: 23.04.2024
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What causes respiratory bronchiolitis associated with interstitial lung disease?
Most smokers develop subclinical bronchiolitis, characterized by an unexpressed or moderate inflammation of the small airways. Few patients who develop a more severe inflammation with a clinically significant interstitial disease are believed to suffer from respiratory bronchiolitis associated with interstitial lung disease (RABAZIL). Men get sick 2 times more often than women. RbAIZIL is characterized by inflammation of the submucosal layer of membranous and respiratory bronchioles, manifested by the presence of dark brown pigmented macrophages (due to an increase in the content of iron in them similar to that observed in smokers), mucus stagnation and metaplastic cube-shaped epithelium located in bronchioles and alveoli. Alveolar septa is always damaged. These changes, however, also occur in some hypersensitivity reactions, occupational lung diseases (usually when exposed to mineral dust), viral infections and reactions to medications. Respiratory bronchiolitis associated with interstitial lung disease also histologically resembles desquamative interstitial pneumonia, but with RBAAZL inflammation is more focal and less extensive. The similarity of the two states led to the assumption that they are different variants of the same disease caused by smoking.
Symptoms of respiratory bronchiolitis associated with interstitial lung disease
Cough and shortness of breath during physical exertion resemble those of other RABAZIL, especially IFL, but are of lesser severity. The only finding in physical examination is wheezing, which are detected during auscultation.
Diagnosis of respiratory bronchiolitis associated with interstitial lung disease
The diagnosis is based on the history, the results of radiation studies, lung function studies and histological examination of the biopsy material. Changes in radiography of the chest are reduced to diffuse enhancement of the pulmonary pattern or focal dimming; thickening of the bronchial walls; hyperplasia of peribronchial interstitial tissue; fine blackouts of regular and irregular shape and small peripheral ring-shaped shadows. KTVR often allows you to identify blackout by the type of frosted glass. Mixed obstructive-restrictive type of impairment in lung function studies is characteristic, although the results may be normal or indicate an isolated increase in residual volume. Investigation of arterial blood gases usually reveals mild hypoxemia. Standard laboratory studies are not informative.
Treatment of respiratory bronchiolitis associated with interstitial lung disease
Treatment of respiratory bronchiolitis associated with interstitial lung disease - cessation of smoking; there is some evidence in favor of the effectiveness of glucocorticoids. The natural nature of the course of the disease is unknown, but its prognosis, provided that smoking is stopped, is favorable.