Bronchiolitis Obliterans Syndrome
Bronchiolitis Obliterans Syndrome is a chronic obstructive pulmonary disease. Bronchiolitis Obliterans Syndrome is often referred to as 'BOS'.
How does one get Bronchiolitis Obliterans Syndrome?
Bronchiolitis Obliterans Syndrome can result from an infection, such as Respiratory Syncytial Virus (also known as RSV).
Bronchiolitis Obliterans Syndrome may result after inhaling toxic fumes.
Bronchiolitis Obliterans Syndrome is now listed as one of the possible side effects of having had a bone marrow transplant. Current statistics provide that it affects about 10% of all patients receiving a bone marrow transplant from a donor.
BOS may result after a single or double lung or heart-lung transplant.
Connective tissue disorders have also resulted in BOS.
What are the symptoms of BOS?
The symptoms are often a dry cough, shortness of breath, wheezing, and fatigue. Symptoms often worsen over time, although people have lived with BOS for decades. The disease can progress very differently for different people.
Is BOS the same as BOOP?
BOS is NOT the same as organizing pnuemonia.
How is BOS diagnosed?
Bronchiolitis Obliterans Syndrome is easiest to diagnose with a CT scan, because that method is less invasive. The CT scan will show pockets of air being trapped in the lungs, which is evidence of the inelasticity of the bronchial tubes. The trapped air is air that has been sent to the lungs to be discarded, so it low in oxygen levels and high in waste gas levels, including carbon dioxide.
Pulmonary function tests are also customarily used in the diagnostic process. Pulmonary function tests are often referred to as PFT's. They involve measuring the amount of air taken into the lungs and expelled from the lungs. The most crucial measurement is the initial expeltion of air, the amount of that air and the quickness with which it can be blown out of the lungs.
Another test that may be conducted in some situations is a lung biopsy. The most common method of obtaining lung tissue for further analysis is with a bronchoscope, which is a lighted instrument that is inserted through the nose or mouth and into the lung. Other methods may be employed as the situation deems necessary.
What causes Bronchiolitis Obliterans Syndrome?
Bronchiolitis Obliterans Syndrome occurs after the above mentioned illnesses as a result of the residual inflammation they caused in the small airways of the lungs. The inflammation severely scars the small airways, and makes them inelastic. The lack of elasticity of the bronchial tubes renders them ineffective in moving air through the lungs, especially out of the lungs. As the disease progresses, the air passages become more restricted.
As the lungs become more restricted, less and less gases are able to be expelled from the lungs, which results in higher and higher levels of carbon dioxide retention in the lungs and therefore in the bloodstream. High levels of carbon dioxide cause fatigue and respiratory duress, making it very, very difficult for the patient to breath. The retained carbon dioxide can also lead to respiratory failure and death.
BOS as a complication of Lung Transplant
In addition to the illnesses listen above, Bronchiolitic Obliterans Syndrome can also result after a lung transplant.
How is BOS treated?
Bronchiolitis Obliterans Syndrome cannot be reversed. It can however be stalled, but the only known effective treatment is a lung transplant. Yes, lung transplants can also cause BOS.
Steroids, corticosteroids, and immunosuppressive medications are often given, and often effectively stall the progression of the disease.
prevention is the name of the game
If a bone marrow transplant patient contracts RSV, he or she may be hospitalized for a minimum of 7 days to be treated for the virus. Prevention strategies are critical. Do all you can to prevent from acquiring RSV. Remember: the primary method of contracting RSV is from a child. While it seems harsh, it is better to be away from your child or children for a week or two than to deal with the consequences of contracting RSV and not being there for them when they grow up.