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Which of the following is most characteristic of bronchiolitis obliterans?
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Teaching Points
- Bronchiolitis obliterans (BO) is characterized by progressive airflow limitation and fibroproliferative thickening of bronchiolar walls. It occurs as a manifestation of rejection in lung transplant recipients as well as in response to inhalational injuries. Therapy for BO is limited.
- For transplant patients with BO, some recommend augmentation of immunosuppression, steroids, and cytolytic therapy.The majority of individuals contract opportunistic infections. This is the most common cause of death.
- When pulmonary function tests are performed, there is decreased air flow during expiration, and reflects as a decreased FEV1, due to the narrowing of the bronchiolar lumen from the fibro proliferative thickening of the walls. Decreased FEV1 is the most diagnostic of BO.
- Spirometry classically shows obstructive flow pattern with decreased FEV1/FVC as well.
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PubMed References
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