Diffuse panbronchiolitis

Dr Henry Knipe and Dr Yuranga Weerakkody et al.

Diffuse panbronchiolitis (DPB) or Asian panbronchiolitis is an idiopathic progressive inflammatory small airway obstructive lung disease.

There is striking predilection in East Asia (e.g. Japan, Korea, China). It tends to present in middle-aged (~ 30-60-year-old) adults, often nonsmokers. There is a high prevalence rate in males with a M:F ratio of ~ 2:1.

It is most likely associated with infections such as H. influenza, P. aeruginosa, and type 1 human T-lymphotropic virus in genetically susceptible people. 

Diffuse panbronchiolitis is characterised by centrilobular peribronchiolar infiltrates of acute and chronic inflammatory cells, which occur principally at the level of the respiratory bronchioles. There can be bronchiolar dilatation and intra-luminal inflammatory exudates. 

Histologically, so-called "DPB unit lesion" is comprised of foamy macrophages and lymphoid infiltrates. 

  • sinusitis

Nonspecific and may show bilateral, diffuse, small nodular shadows with pulmonary hyperinflation.

A peripherobasilar predilection may be present. Features are generally non-specific and include:

Often treated with long-term low dose erythromycin. If untreated can be progressive even leading to death.

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Article information

rID: 11070
System: Chest
Tag: cases
Synonyms or Alternate Spellings:
  • Diffuse panbronchiolitis (DPB)
  • Diffuse pan-bronchiolitis

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