Adult bronchiolitis diagnostic study of choice
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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]
Overview
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, the gold standard for diagnosis of adult bronchiolitis is clinical assessment. However, pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.
Diagnostic Study of Choice
There is no single diagnostic study of choice for the diagnosis of adult bronchiolitis, the gold standard for diagnosis of adult bronchiolitis is clinical assessment. However, pulmonary function testing, high resolution computed tomography (HRCT), and bronchoscopy may be useful in the diagnosis of adult bronchiolitis.[1][2][3][4][5]
Diagnostic results
- The following result of pulmonary function test is suggestive of adult bronchiolitis:
- Normal PFT or
- Obstructive or restrictive changes with atelectasis
- Irreversibility following inhaled bronchodilator
- Decreased carbon monoxide diffusing capacity
- The following result of high resolution CT is suggestive of adult bronchiolitis:
- Mosaic or diffuse air trapping
- Bronchial wall thickening
- Linear opacities
- Centrilobular nodules
- Bronchiectasis (dilated airways)
- Specifically seen in:
- Bronchiolitis obliterans
- Following lung transplant
- Rheumatic disease
- Previous infection
- Toxic fume inhalation
- Specifically seen in:
- Bronchoscopy does not have any specific findings that suggest adult bronchiolitis, however, bronchoscopy may be useful for:
- Identifying features of other respiratory pathologies, such as:
- Increased lymphocytic count in hypersensitivity pneumonitis
- Necrotizing granulomata in sarcoidosis
- Infection
- Malignancy
- Lung transplant function deterioration causes
- Identifying features of other respiratory pathologies, such as:
Sequence of Diagnostic Studies
- The investigation fro adult bronchiolitis should be performed when:
- The patient presented with insidious onset of cough and dyspnea, with a pattern unlike chronic obstructive pulmonary disorder and asthma.
Diagnostic Criteria
There are no established criteria for the diagnosis of adult bronchiolitis.
References
- ↑ Devakonda A, Raoof S, Sung A, Travis WD, Naidich D (April 2010). "Bronchiolar disorders: a clinical-radiological diagnostic algorithm". Chest. 137 (4): 938–51. doi:10.1378/chest.09-0800. PMID 20371529.
- ↑ Pipavath SJ, Lynch DA, Cool C, Brown KK, Newell JD (August 2005). "Radiologic and pathologic features of bronchiolitis". AJR Am J Roentgenol. 185 (2): 354–63. doi:10.2214/ajr.185.2.01850354. PMID 16037505.
- ↑ Jensen SP, Lynch DA, Brown KK, Wenzel SE, Newell JD (December 2002). "High-resolution CT features of severe asthma and bronchiolitis obliterans". Clin Radiol. 57 (12): 1078–85. PMID 12475532.
- ↑ Barker AF, Bergeron A, Rom WN, Hertz MI (May 2014). "Obliterative bronchiolitis". N. Engl. J. Med. 370 (19): 1820–8. doi:10.1056/NEJMra1204664. PMID 24806161.
- ↑ Ghanei M, Tazelaar HD, Chilosi M, Harandi AA, Peyman M, Akbari HM, Shamsaei H, Bahadori M, Aslani J, Mohammadi A (June 2008). "An international collaborative pathologic study of surgical lung biopsies from mustard gas-exposed patients". Respir Med. 102 (6): 825–30. doi:10.1016/j.rmed.2008.01.016. PMID 18339530.