Constrictive bronchiolitis

Question 1

Definition of constrictive bronchiolitis

Answer 1

Extrinsic compression of bronchioles caused by fibroinflammatory process of the submucosa region

Question 2

Causes of constrictive bronchiolitis

Answer 2

CRITTS
C: Cryptogenic constrictive bronchiollitis
R: RA (inc other autoimmune - SLE, Sjogren)
I: IBD, post-infection (e.g. RSV, influenza, mycoplasma)
T: Transplant - lung or bone marrow recipient
T: Toxin (inhalation e.g. cocaine, Nitrogen oxide in fertilizer production, diacetyl in vape)
S: Sarcoidosis

Question 3

Features of constrictive bronchiolitis on HRCT

Answer 3

air trapping
bronchial wall thickening
bronchiectasis

Question 4

How to treat obstructive bronchiolitis (5)

Answer 4

1) Rx underlying cause –
if caused by toxin –> remove exposure
in CTD-related–> immunosupp
in post bone marrow transplant –> inhaled ICS, montelukast, azithromycin
2) Rx coexisting infection/colonisation
3) Rx GERD/ aspiration risk
4) Optimise nutrition
5) Pulm rehab

Question 5

Types of primary bronchiolar disorders

Answer 5

Question 6

Images of bronchiolar disorders

Answer 6