Diffuse Panbronchiolitis


Diffuse panbronchiolitis is a rare lung disease that is sometimes included in a differential diagnosis of COPD. It has no known cause and primarily affects the bronchioles, the smallest airways of the lungs, causing severe, progressive inflammation and obstruction. Left untreated, diffuse panbronchiolitis leads to bronchiectasis, respiratory failure and eventually, death.


Typically, symptoms of diffuse panbronchiolitis occur during the second to fifth decade of life and include:

  • Cough
  • Large amounts of sputum (up to 50 milliliters per day in some patients)
  • Dyspnea with minimal activity
  • Wheezing


More than 80 percent of patients who suffer from diffuse panbronchiolitis have a long-term history of sinusitis. This is important when making a diagnosis, which may also include the following tests:


Historically, treatment with medications such as bronchodilators and corticosteroids did little to help avoid the diseases' potentially fatal outcome. Since then, the following macrolide antibiotics have proven effective for a period of up to two years:

  • Low doses of erythromycin
  • Clarithromycin or roxithromycin (when erythromycin is ineffective)


Prior to the discovery that erythromycin helped successfully treat the disease, the prognosis of diffuse panbronchiolitis was poor.

To date, long-term treatment with erythromycin has been found to increase the 10-year survival rate of the disease to greater than 90 percent.

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