Clinical Relevance of Bronchial Anthracofibrosis in Patients with Chronic Obstructive Pulmonary Disease Exacerbation

Abstract

BackgroundBronchial anthracofibrosis (BAF), which is associated with exposure to biomass smoke in inefficiently ventilated indoor areas, can take the form of obstructive lung disease. Patients with BAF can mimic or present with an exacerbation of chronic obstructive pulmonary disease (COPD). The purpose of the current study was to investigate the prevalence of BAF in Korean patients with COPD exacerbation as well as to examine the clinical features of these patients in order to determine its clinical relevance.MethodsA total of 206 patients with COPD exacerbation were divided into BAF and non-BAF groups, according to computed tomography findings. We compared both clinical and radiologic variables between the two groups.ResultsPatients with BAF (51 [25%]) were older, with a preponderance of nonsmoking women; moreover, they showed a more frequent association with exposure to wood smoke compared to those without BAF. However, no differences in the severity of illness and clinical course between the two groups were observed. Patients in the BAF group had less severe airflow obstruction, but more common and severe pulmonary hypertension signs than those in the non-BAF group.ConclusionCompared with non-BAF COPD, BAF may be associated with milder airflow limitation and more frequent signs of pulmonary hypertension with a more severe grade in patients presenting with COPD exacerbation.

Clinical and radiological manifestations of lipoid pneumonia according to etiology: Squalene, omega‐3‐acid ethyl esters, and idiopathic

“…Bronchoscopic data were reviewed with respect to the presence of bronchial anthracofibrosis (BAF) and BAL fluid analysis where differential cell counts of white blood cells and lymphocyte subsets determined by flow cytometry were included. BAF was defined as multiple dark pigmentations observed on the bronchial mucosa on bronchoscopy …”

“…BAF was defined as multiple dark pigmentations observed on the bronchial mucosa on bronchoscopy. [16][17][18]…”

Proposed Etiotypes for Chronic Obstructive Pulmonary Disease: Controversial Issues

“…Also, several studies reported the association between pulmonary TB and BAF [ 85 ]. This disease entity is often diagnosed as asthma or COPD because of similar spirometric findings, i.e., obstructive spirometry pattern [ 87 ].…”

“…In Korea, the rate of having BAF in COPD seems relatively frequent. According to a single-center respective study in Korea, one-fourth of the individuals had a BAF based on CT criteria among the those with COPD exacerbation [ 87 ]. From a pathologic view, BAF and COPD both commonly affect small airways despite their distinct patterns of pathological changes ( Table 3 ) [ 91 ].…”

Small Airway Disease in COPD Associated to Biomass Exposure

“…A growing body of evidence supports that COPD caused by chronic indoor exposure to biomass smoke, in contrast to COPD due to cigarette smoke, is predominantly a disease of the airways with mild or minimum emphysema [6][7][8][34][35][36][37][38] . Although recent studies have focused on the small airways' damage in BE-COPD 8,38 , bronchial anthracofibrosis affecting also the central airways seems a trait more frequent and severe in BE-COPD than in TE-COPD, which could cause bronchial stenosis 8,[39][40][41] . In the following paragraphs, we present some of the evidence and characteristics of the airways' damage in BE-COPD.…”