| Objective To improve the identification of diffuse panbronchiolitis (DPB) by report a case and analysing the clinical characteristics, diagnosis and treatment of Chinese patients with DPB.Methods Report a case treated in our hospital and analyse DPB cases reported in mainland China from1996to2014.Results Here we report a case of an old women with chronic cough and sputum production. Cold agglutinins test was positive. CT showed diffuse nodular shadows. Sinus CT showed manifestation of sinusitis. She was diagnosed with DPB and received macrolides treatment which relived the symptoms. However, the symptoms aggravated after half year with decline of lung function. She continued therapy of macrolides, and symptoms relieved again. The manifestation of chest CT improved after2years. We analysed DPB cases reported in mainland China, and conclued the clinical characteristics of106cases:(1) Among106patients, the ratio of male and female was1.7to1. The average age was46.6, ranging from10to82. The patients were distributed all over the country.(2) All the patients presented with chronic cough and sputum production. Most of them had dyspnea. Rales could be found in some patients.(3)90.6%patients had the history and X-ray manifestation of sinusitis.(4)57.7%sputum cutrure found Pseudomonas aeruginosa.(5) Cold agglutination test was positive in58.9%cases;(6)Human leukocyte antigen-B54was positive in60%patients.(7) Pulmonary function test showed obstructive dysfunction in47.8%cases and mixed obstructive-restrictive pattern in48.9%cases.(8) Almost all the X-ray and CT showed diffuse nodular shadows.(9) Patients were often misdiagnosed with chronic bronchitis, bronchiectasis, tuberculosis and athsma.(10) Macrolides were effective. After3months of treatment, the symptoms were relieved in most patients.Conclusion DPB is not rare in China. Patients were often misdiagnosed. Macrolides can significantly improve the prognosis. To enhance the awareness of DPB can improve the diagnosis rate. |
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