From the Guidelines
Popcorn lung, or constrictive bronchiolitis, is a serious and irreversible lung disease that requires immediate medical attention if suspected, with treatment focusing on managing symptoms and preventing further damage, as stated in the most recent consensus statements 1.
Key Points
- The condition is characterized by scarring of the small airways (bronchioles), making it difficult to breathe, and is often associated with inhalational exposures such as diacetyl, a chemical used for butter flavoring in microwave popcorn factories 1.
- There is no cure for popcorn lung, and treatment typically includes bronchodilators to open airways, corticosteroids to reduce inflammation, and oxygen therapy in severe cases.
- Avoiding exposure to causative agents is crucial for prevention, and symptoms include dry cough, shortness of breath, wheezing, and fatigue that worsen over time.
- The disease progresses gradually, with lung function declining as more bronchioles become scarred and narrowed, ultimately affecting oxygen exchange in the lungs.
Diagnosis and Treatment
- Surgical lung biopsy is necessary for the diagnosis of constrictive bronchiolitis, as it provides a definitive diagnosis, and other diagnostic methods may not identify a clear cause of respiratory symptoms 1.
- The longitudinal behavior of constrictive bronchiolitis and other undiagnosed respiratory conditions in deployed individuals is not well characterized, and more data are required to determine the prevalence of the condition 1.
- Respiratory symptoms may be improved by managing comorbidities and/or pulmonary rehabilitation, but there is no proven treatment for individuals with constrictive bronchiolitis 1.
Prevention and Management
- Avoiding exposure to causative agents, such as diacetyl, is crucial for prevention, and individuals who have been exposed to such agents should be monitored closely for symptoms of popcorn lung.
- Early diagnosis and treatment can help manage symptoms and prevent further damage, and individuals who suspect they have popcorn lung should seek immediate medical attention.
From the Research
Definition and Causes of Popcorn Lung
- Popcorn lung, also known as bronchiolitis obliterans, is a disease of the small airways that results in progressive dyspnea and airflow limitation 2.
- It can occur as a complication of certain pulmonary infections, adverse drug reactions, toxic inhalation, and autoimmune disorders 2.
- Non-transplant-related bronchiolitis obliterans is rare and can mimic asthma and chronic obstructive pulmonary disease (COPD) 2.
Diagnosis and Treatment
- The diagnosis of bronchiolitis obliterans can be suggested by obstructive changes in serial pulmonary function testings, while open lung biopsy is usually required in non-transplant cases 2.
- High-resolution computerized tomography (HRCT) is also a helpful tool to diagnose and assess the severity of bronchiolitis obliterans 2.
- The treatment of bronchiolitis obliterans, regardless of the cause, is usually disappointing, with systemic corticosteroid immunosuppression and retransplantation having variable success 2, 3.
Relationship to Lung Transplantation
- Bronchiolitis obliterans syndrome (BOS) is a form of chronic lung allograft dysfunction that affects a majority of lung transplant recipients and is the principal factor limiting long-term transplant survival 4.
- BOS is characterized by progressive airflow obstruction unexplained by acute rejection, infection, or other coexistent condition 4.
- Preventive efforts are aimed at alleviating known risk factors of BOS development, while the primary goal of treatment is to delay the irreversible, fibrotic airway changes, and progressive loss of lung function 3.