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{{Bronchiolitis obliterans}}
'''Editor-in-Chief:''' Kaochoy Saechao, MD, MPH


'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


{{CMG}},;{{AE}}{{HM}}


==Overview==


'''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


==Etiology==
==[[Bronchiolitis obliterans overview|Overview]]==


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]]==


==Presentation==
==[[Bronchiolitis obliterans classification|Classification]]==


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]]==


==Diagnosis==
==[[Bronchiolitis obliterans causes|Causes]]==


Bronchiolitis obliterans patients should be seen by a board-certified Pulmonologist for accurate diagnosis.
==[[Bronchiolitis obliterans differential diagnosis|Differentiating Bronchiolitis obliterans from other Diseases]]==


==Prognosis/treatment==
==[[Bronchiolitis obliterans epidemiology and demographics|Epidemiology and Demographics]]==


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]]==


==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|^}}
 
Industrial workers who have presented with bronchiolitis:
*nylon-flock workers {{ref label|Hazmap|6|^}}
*workers who spray prints onto textiles with polyamide-amine dyes {{ref label|Hazmap|6|^}}
*battery workers who are exposed to thionyl chloride fumes
*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|^}}


==[[Bronchiolitis obliterans natural history, complications and prognosis|Natural History, Complications and Prognosis]]==


==Diagnosis==


==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]]


* [[Diacetyl]]
==Treatment==
* [[Bronchiolitis obliterans organizing pneumonia]]


==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]]


==Case Studies==
[[Bronchiolitis obliterans case study one|Case #1]]


* 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==
 
* 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]
 
==Sources==
 
* Brant & Helms. ''Fundamentals of Diagnostic Radiology'' LWW, 1999.
* Webb, et al. ''High Resolution CT of the Lung''. 3rd edition. LWW, 2000.
* Harber, Philip; Saechao, Kaochoy; & Boomus, Catherine.  ''Diacetyl-induced lung ''  Toxicological Reviews 2006;vol 25(4):261-72.
 
==References==
 
#{{note label|Brant|1|^}}{{cite book | author=Brant & Helms| title=Fundamentals of Diagnostic Radiology |  year=1999 | }}
#{{note label|Webb|2|^}}{{cite book | author=Webb, et al| title=High Resolution CT of the Lung | edition=3rd Edition | year=2000 | }}
#{{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 | }}
#{{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]
#{{note label|Colby|5|^}} Colby, T.V. "Bronchiolitis, Pathologic Considerations". ''Am J Clin Pathology'' 1998;109:101-9
#{{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.]
#{{note label|CalOSH|7|^}}[http://www.dhs.ca.gov/ohb/flavoringcases.pdf/ California Department of Health Services]
#{{note label|NEJM|8|^}}E. Neil Schachter. "Popcorn Workers' Lung". ''New England Journal of Medicine'' 2002;347(5):360-1.
#{{note label|Egilman|9|^}}David Egilman (2007). [http://www.ijoeh.com/pfds/IJOEH_1301_Egilman.pdf "Popcorn Workers Lung"]
#{{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.
#{{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''
#{{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''
#{{note label|Reuters|13|^}}Reuters New Report: [http://uk.reuters.com/article/healthNews/idUKN0524254120070905 FDA to probe popcorn link in man's lung disease].
#{{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"]}}.
#{{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]
 


* [[Diacetyl]]
* [[Bronchiolitis obliterans organizing pneumonia]]


[[Category:Pulmonology]]
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[[Category:Occupational safety and health| ]]
[[Category:Occupational safety and health| ]]
[[Category:Industrial hygiene]]
[[Category:Industrial hygiene]]
[[de:Bronchiolitis obliterans]]


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Latest revision as of 17:50, 22 February 2018

Bronchiolitis obliterans
DiseasesDB 1704
MeSH D001989

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1],;Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]


Synonyms and keywords: Obliterative bronchiolitis; proliferative bronchiolitis; bronchiolitides; popcorn lung; popcorn lung disease; popcorn workers' lung; diacetyl-induced bronchiolitis obliterans

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Bronchiolitis obliterans from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria | History and Symptoms | Physical Examination | Laboratory Findings | Chest X ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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