Constrictive bronchiolitis obliterans. Report of one case

Introduction. - Constrictive bronchiolitis obliterans is defined histologic ally as obliteration of the lumina of bronchioles by inflammatory tissue el ements and progressive destruction of bronchioles, eventually replaced by f ibrotic tissue, Most of the cases, which are not associated with either sol id organ or bone marrow transplantation occur in the development of rheumat oid arthritis. Exegesis. - We present the case of a 73-year-old woman who developed severe constrictive bronchiolitis obliterans without readily identifiable cause, rapidly fatal despite corticosteroid therapy. The patient had antinuclear a ntibodies (titer 1/1024) and antiphospholipid antibodies, but there was no anti-DNA, anti-ENA or anti-beta2GPI antibodies. Tests for rheumatoid factor were negative. Cryoglobulinemia was present (monoclonal IgM Kappa). Conclusion, - In this case, constrictive bronchiolitis obliterans was assoc iated with serologic abnormalities and cryoglobulinemia. However, there was no clinical evidence of connective tissue disease. (C) 1999 Elsevier, Pari s.