DIFFUSE PANBRONCHIOLITIS AND RHEUMATOID ARTHRITIS-ASSOCIATED BRONCHIOLAR DISEASE - SIMILARITIES AND DIFFERENCES

There is a considerable overlap between diffuse panbronchiolitis (DPB) and bronchiolar disease associated with rheumatoid arthritis, The pre sent study assessed how these conditions could be differentiated. The subjects included 25 DPB patients and 15 RA patients with bronchiolar disease (RA-BD), Patients with either condition had chronic cough, pur ulent sputum, dyspnea and coarse crackles. Most patients with either D PB or RA-BD had a history of sinusitis as well as elevated cold hemagg lutin titers and decreased levels in partial pressure of oxygen (PaO2) , forced expiratory volume in one second (FEV1.0) and (V) over dot 25/ Ht, On histological examination, both conditions also shared various h istological patterns although panbronchiolitis lesions were more commo n in DPB than RA-BD (68% vs 20%) and bronchiolar obliteration appeared to occur at more proximal sites in RA-BD than DPB. However, there wer e important differences: long-term treatment with erythromycin had les s effect in RA-BD than DPB, and the frequency of HLA B54 tended to be higher in DPB than RA-BD (50.0% vs 22.2%), suggesting that they are di stinct conditions.