Chest
Volume 107, Issue 4, April 1995, Pages 1176-1178
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Selected Reports
Diffuse Panbronchiolitis in a Hispanic Man With Travel History to Japan

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Diffuse panbronchiolitis is a chronic airflow disorder of obscure origin, which has been reported infrequently outside of Japan and never with any long-term follow-up. We report such a case in a Hispanic man. Furthermore, this patient had an extensive travel history to the Far East, including Japan. This case raises the possibility of a poorly transmissible infectious agent responsible for the disease.

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CASE REPORT

A 47-year-old Hispanic man presented in 1977 with a two-year history of exercise-induced dyspnea, wheezing, and persistent cough with intermittent yellow sputum production. The patient was not a smoker. Pulmonary function tests showed a mixed obstructive-restrictive pattern with a forced vital capacity (FVC) of 2.34 and FEV1 of 1.24. Routine bacteriologic, fungal, and mycobacterial cultures were negative. Chest radiographs showed innumerable small (3 to 4 mm) peripheral nodules. The patient's

DISCUSSION

Our patient presented with chronic cough, chronic sinusitis, worsening exertional dyspnea, progressive hypoxia, and mixed obstructive-restrictive pulmonary function test results. Laboratory findings showed elevated serum IgA, IgG, and cold agglutinin titers with negative mycoplasma titers. The original lung biopsy ultimately was interpreted as diffuse panbronchiolitis. The clinical history of this disease is characteristic in Japan.3

The causative factors for diffuse panbronchiolitis are

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