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- Title
Thin-section computed tomography findings before and after azithromycin treatment of neutrophilic reversible lung allograft dysfunction.
- Authors
de Jong PA; Vos R; Verleden GM; Vanaudenaerde BM; Verschakelen JA; de Jong, Pim A; Vos, Robin; Verleden, Geert M; Vanaudenaerde, Bart M; Verschakelen, Johny A
- Abstract
<bold>Objectives: </bold>Recently a novel subgroup of bronchiolitis obliterans syndrome (BOS) has been described in patients after lung transplantation with high neutrophil counts in broncho-alveolar lavage and recovery of lung functional decline with azithromycin treatment. We aimed to describe the thin-section computed tomography (CT) findings of these neutrophilic reversible allograft dysfunction (NRAD) patients before and after azithromycin.<bold>Methods: </bold>A cohort of 100 lung transplant recipients with BOS were treated with azithromycin and underwent lung function testing, broncho-alveolar lavage and CT before azithromycin treatment and during follow-up. The 200 CT data sets were scored for bronchial dilatation, mucus plugging, centrilobular abnormalities, airway wall thickening, consolidation, ground glass and end-expiratory air trapping.<bold>Results: </bold>NRAD was characterized by more centrilobular abnormalities on CT (p = 0.03 for prevalence and p = 0.06 for severity) compared to non-responders. At follow-up NRAD patients showed improvement in all CT abnormalities including air trapping, but the degree of improvement in all CT abnormalities was significantly different between responders and non-responders (who showed progression of bronchus dilatation, consolidation and air trapping).<bold>Conclusions: </bold>Within BOS patients those with NRAD differ from azithromycin non-responders by more centrilobular abnormalities on CT before azithromycin and improvement in bronchus dilatation, consolidation and air trapping during treatment.
- Publication
European Radiology, 2011, Vol 21, Issue 12, p2466
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-011-2224-1