Diagnosis and Management of Small Airways Disease
Persistent Notes
this is a test
Highlights
- asthma and COPD p.1
- bronchiolitis syndromes p.1
- small airways are airways # 2 mm in diameter p.1
- most of the crosssectional area p.1
- contribute little to airway resistance p.1
- complete luminal occlusion p.2
- mucus impaction or proliferation of fibrotic tissue p.2
- reduction in luminal diameter p.2
- infiltration p.2
- bronchiolitides p.2
- Clinical Categories of Small Airways Disease p.2
- inflammatory infiltrate p.2
- Acute bronchiolitis p.2
- infection p.2
- neutrophilic infiltrate p.2
- constriction and obstruction p.2
- lower respiratory tract infection p.2
- Lymphocytic bronchiolitis p.2
- bronchial walls with relative sparing of the interstitium p.2
- ollicular bronchiolitis (FB) and lymphoid interstitial pneumonia (LIP) p.2
- inflammatory exudates and extrinsic compression p.2
- represent hyperplasia of ectopic bronchus-associated lymphoid tissue p.3
- rheumatologic and immune disorders, p.3
- idiopathic p.3
- nylon flocking plants p.3
- metalworking fluids and bacterial endotoxin p.4
- Granulomatous bronchiolitis p.4
- inflammatory bowel disease, hypersensitivity pneumonitis, sarcoidosis, and mycobacterial infection p.4
- Eosinophilic bronchiolitis p.4
- Respiratory bronchiolitis p.4
- tan pigmented macrophages p.4
- Smooth muscle hypertrophy and scarring of the bronchiolar wall p.4
- smoke p.4
- respiratory bronchiolitis-associated interstitial lung disease p.4
- Proliferative Bronchiolitis p.4
- myofibroblastic connective tissue p.4
- bronchiolitis obliterans p.4
- BO organizing pneumonia (OP) p.4
- syndrome of airway obstruction after organ transplantation p.4
- bronchiolitis obliterans syndrome p.4
- concentric narrowing of the bronchioles p.4
- chronic lung allograft dysfunction (CLAD) p.4
- BOS is an uncommon manifestation of chronic graft-vs-host disease p.4
- nontransplant patients p.4
- autoimmune disease, p.4
- military conflict. Sulfur mustard p.4
- civilian occupational exposures. p.5
- resins in fiberglass manufacturing p.5
- (EVALI p.5
- Diffuse Panbronchiolitis p.5
- never smoked p.5
- chronic sinusitis and airway infectio p.5
- bronchiolitis is typically reserved for nonasthma/COPD conditions, even though small airways inflammation is also present in both asthma and COPD p.5
- dyspnea and coug p.5
- crackles or expiratory wheezing p.5
- Pulmonary function testing p.5
- mean forced expiratory flow between 25% and 75% of FVC p.6
- high levels of variability, p.6
- hyperinflation and gas trapping p.6
- small airways diseases p.6
- . Gas washout techniques (eg, nitrogen washout, helium washout) can provide information about ventilation heterogeneity, p.6
- Impulse oscillometry p.6
- best characterized in asthma p.7
- bronchiolar wall thickening with surrounding inflammation and edema p.7
- tree-in-bud nodules p.7
- mosaic attenuation p.7
- pulmonary vascular disease, pulmonary edema, infection, and even under normal conditions in some patients. p.7
- xenon CT scan p.7
- hyperpolarized gas MRI p.7
- histopathology provides conclusive evidence p.7
- open biopsy using VATS p.7
- underlying process p.7
- mall airways involvement as a component of COPD pathology p.7
- treatment for patients with CTDs with small airways involvement is poorly defined p.7
- Bronchiolitis in rheumatoid arthritis p.7
- immunosuppression p.7
- Macrolides may also have a role p.8
- Patients with DPB respond well to treatment with erythromycin p.8
- Macrolides are frequently p.8
- Azithromycin p.8
- slow or arrest the decline in FEV1 p.8
- antiinflammatory effects p.8
- BAL neutrophilia p.8
Reference
Tancredi M, Strek ME, Williams KM, Kimmig L. Diagnosis and Management of Small Airways Disease. CHEST Pulmonary. 2026;4(2):100211. doi:10.1016/j.chpulm.2025.100211