Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Airway diseases

Abstract

Introduction
There is few data about war related bronchiolitis obliterans (BO) treatment. We compared FVC and FEV1 changes during BO treatment in comparison to non bronchiolitis obstructive pulmonary disease in a cohort of chemical victims.
Materials and methods
Seventy two Iranian veterans, with chronic pulmonary disease were followed from September 2005 to December 2010. All of them had documented exposure to Sulfur Mustard gas from 1982 to 1988.
The bronchiolitis group (diagnosed based on HRCT and/or biopsy) was treated with inhaled Seretide (500-1000 µg/day), Azithromycin (500 mg/3 times per week) and N-acetylcysteine (1200-1800/day). The non bronchiolitis patients were treated according to GINA and GOLD guidelines.
Results
16 patients had BO and 56 had non bronchiolitis obstructive pulmonary disease. The baseline FVC and FEV1 were not different between bronchiolitis and non bronchiolitis groups. Mean FVC and FEV1 has decreased significantly during the 5 years followup despite standard treatments in all patients (baseline FVC=3.50+/-0.78 L, Final FVC=3.21+/-0.75 L; P<0.001) and (baseline FEV1=2.77+/-0.80 L, Final FEV1=2.47+/-0.77 L; P<0.001). The FVC and FEV1 changes in bronchiolitis group were -0.30+/-0.18L and -0.15+/0.521 L respectively. It was not significantly different from FVC and FEV1 changes in non bronchiolitis group (-0.29+/-0.58L and-0.34+/-0.62 L respectively).
Discussion
The five year spirometric parametric changes were not different between bronchiolitis and non bronchiolitis group in mustard gas victims. This finding suggests the long term efficacy of treatment with inhaled steroid, macrolide and N-acetylcysteine in war related bronchiolitis obliterans.

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Citations should be made in the following way:
H. Abtahi, S. Peiman, M. Moeinzad Tehrani (Tehran, Islamic Republic Of Iran). Long term efficacy of war related bronchiolitis obliterans treatment. Eur Respir J 2011; 38: Suppl. 55, 487

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