A clinical study on diffuse panbronchiolitis

Five cases with diffuse panbronchiolitis were studied with a battery of lung scintigraphy, pulmonary function test and other clinical findings. Symptoms and signs observed were cough, exertional dyspnea, purulent sputum and moist rales in all cases, fever in 4, right-sided heart failure in 1, elevated ESR and hyper #betta#-globulinemia in 4, positive CRP and high titer of cold agglutinin in 2, positive RA test in all, neutrophilia in only one and Pseudomonas aeruginosa was isolated from sputum in 2 cases. The abnormalities in pulmonary function were decreased vital capacity and forced expiratory volume in all case, increased residual volume, decreased V50 and V25 in flow volume curve and abnormal distribution of inspired gas in 3 of 3 tested cases, decreased diffusion capacity in 2 of 3, hypoxemia in all and hypercapnia in 2 of 5 cases. On chest x-ray film, fine nodular shadows throughout both lungs with tram line shadows in lower lung fields were shown in 4 cases and overinflation in one case. In Tl-201 scintigram of 3 cases, slight or negative lung uptake and positive visualization of the right ventricle were observed in all cases. In Hg-197 chloride scintigram of 2 cases, lung uptake was moderate and slight respectively. In perfusion lung scintigram of 5 cases, marked decrease in perfusion especially in lower lung fields was shown in all cases, and many scattered small areas of hypoperfusion throughout both lung were demonstrated in one case. (author)