title: Diffuse panbronchiolitis-The response and recurrence after erythromycin therapy.
abstract: OBJECTIVE
  Diffuse panbronchiolitis (DPB) is a rare clinicopathological entity. To date, no cohort study of DPB has been conducted in Taiwan. Erythromycin treatment improves the clinical outcome of DPB; however, whether relapse will occur or not is unclear. Herein, we report the first retrospective cohort of DPB patients in one medical center in Taiwan, including their clinical presentation and outcomes of erythromycin treatment.
  
  
  METHODS
  The study comprised a retrospective cohort analysis of 27 patients with a confirmed diagnosis of DPB. Clinical, radiological, and laboratory parameters were analyzed, and the course and outcome of erythromycin treatment were examined.
  
  
  RESULTS
  The mean age at symptom onset was 56.6 ± 18.5 years, and the time between symptom onset and a correct diagnosis was 4.3 ± 4.2 years. The percentages of patients with centrilobular micronodules on chest computed tomography, obstructive ventilator impairment with hypoxemia, and an elevated cold agglutinin titer were 72%, 37%, and 78%, respectively. After erythromycin treatment, 22 of the 27 (81.5%) patients showed clinical improvement, of whom six suffered a relapse. Four of these six patients clinically improved after a second course of erythromycin treatment.
  
  
  CONCLUSIONS
  Erythromycin therapy was suitable for DPB in our experience. In this study cohort, 27% experienced a relapse, of which two-thirds of the patients improved after a second course of erythromycin treatment.
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taiwan.
authors.forename: Min-Chun
authors.initials: MC
authors.lastname: Chuang
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Taiwan.
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chou
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Taiwan.
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Taiwan.
authors.forename: Meng-Jer
authors.initials: MJ
authors.lastname: Hsieh
authors.affiliation: Department of Pulmonary and Critical Care Medicine, Chiayi Chang-Gung Memorial Hospital, Taiwan. Electronic address: chestmed@adm.cgmh.org.tw.
authors.forename: Ying-Huang
authors.initials: YH
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001988:Bronchiolitis / Q000188:drug therapy*; D002908:Chronic Disease; D004917:Erythromycin / Q000008:administration & dosage*; D005260:Female; D006192:Haemophilus Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013624:Taiwan; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004917:Erythromycin
keywords: Taiwan; diffuse panbronchiolitis; erythromycin