[Diffuse panbronchiolitis: DPB].
Diffuse panbronchiolitis (DPB) is a chronic inflammatory airway disease which was lethal in the past despite combined treatment with antibiotics and the use of supportive therapies such as oxygen administration. Diagnosis of DPB is performed according to the diagnostic criteria that include major items: symptoms, existence of parasinusitis, chest radiographic findings, minor items: physical signs (coarse crackles), pulmonary functions and blood gas tests, and elevated titers of cold hemagglutinin. Pathological feature shows thickness of the wall of respiratory bronchiole with infiltration of lymphocytes, plasma cells, and foamy histiocytes expanded into the peribronchiolar area. Many of these bronchiolitis progress respiratory failure with bronchiectasis in advanced stage. Recently, DPB was interested in genetic predisposition because of high accumulation in the East Asia with the same HLA haplotype. Low-dose of erythromycin (400-600 mg/day) is a authorized therapy to improve the survival time of patients with DPB. 14-membered ring macrolides other than erythromycin also improve the survival of DPB patients.
Azuma
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Fourth Dept. Int. Med., Nippon Medical School.
Kudoh
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D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001988:Bronchiolitis / Q000188:drug therapy / Q000235:genetics; D004917:Erythromycin / Q000008:administration & dosage; D020022:Genetic Predisposition to Disease; D006680:HLA Antigens / Q000235:genetics; D006801:Humans
D000900:Anti-Bacterial Agents; D006680:HLA Antigens; D004917:Erythromycin