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Article in Japanese
A case of diffuse aspiration bronchiolitis resulting from gastroesophageal reflux disease provoked by habitual drinking
Shunsuke Umetani Ryuichi Sato Kazuhiro Takenaka Keiko Okuno Miho Nakamura Yasuhiro Funada
Department of Respiratory Medicine, Takatsuki General Hospital
A 47-year-old man was admitted to our hospital with complaints of chronic cough and chest radiographic abnormality. Chest computed tomography (CT) showed bilateral diffuse centrilobular nodules. Transbronchial lung biopsy specimens showed nonspecific findings. Since the chest CT findings worsened six months later, a video-assisted thoracoscopic lung biopsy was performed for diagnosis. Histological findings showed a variety of foreign body granulomas around bronchioles, which suggested aspiration. We diagnosed him as diffuse aspiration bronchiolitis (DAB). His swallowing function was normal on fiberoptic endoscopic evaluation. A detailed history taking revealed that he often took sleeping pills with alcohol and vomited while sleeping. Hiatal hernia was detected by upper gastrointestinal endoscopy. Gastroesophageal reflux disease was suspected to cause DAB. After he had permanently stopped drinking alcohol, the nocturnal vomiting almost disappeared and chest CT findings improved. DAB should be recognized as a differential diagnosis in patients with diffuse nodular shadows on chest CT, and detailed history concerning aspiration, including GERD, should be taken even in the case of nonelderly population.
Diffuse aspiration bronchiolitis Gastroesophageal reflux disease Esophageal hiatal hernia Depressive disorder Alcohol drinking
Received 20 Nov 2015 / Accepted 24 Mar 2016
AJRS, 5(4): 199-203, 2016