| Constrictive bronchiolitis in soldiers returning from Iraq and Afghanistan. | |
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MedLine Citation:
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PMID: 21774710 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: In this descriptive case series, 80 soldiers from Fort Campbell, Kentucky, with inhalational exposures during service in Iraq and Afghanistan were evaluated for dyspnea on exertion that prevented them from meeting the U.S. Army's standards for physical fitness. METHODS: The soldiers underwent extensive evaluation of their medical and exposure history, physical examination, pulmonary-function testing, and high-resolution computed tomography (CT). A total of 49 soldiers underwent thoracoscopic lung biopsy after noninvasive evaluation did not provide an explanation for their symptoms. Data on cardiopulmonary-exercise and pulmonary-function testing were compared with data obtained from historical military control subjects. RESULTS: Among the soldiers who were referred for evaluation, a history of inhalational exposure to a 2003 sulfur-mine fire in Iraq was common but not universal. Of the 49 soldiers who underwent lung biopsy, all biopsy samples were abnormal, with 38 soldiers having changes that were diagnostic of constrictive bronchiolitis. In the remaining 11 soldiers, diagnoses other than constrictive bronchiolitis that could explain the presenting dyspnea were established. All soldiers with constrictive bronchiolitis had normal results on chest radiography, but about one quarter were found to have mosaic air trapping or centrilobular nodules on chest CT. The results of pulmonary-function and cardiopulmonary-exercise testing were generally within normal population limits but were inferior to those of the military control subjects. CONCLUSIONS: In 49 previously healthy soldiers with unexplained exertional dyspnea and diminished exercise tolerance after deployment, an analysis of biopsy samples showed diffuse constrictive bronchiolitis, which was possibly associated with inhalational exposure, in 38 soldiers. |
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Authors:
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Matthew S King; Rosana Eisenberg; John H Newman; James J Tolle; Frank E Harrell; Hui Nian; Mathew Ninan; Eric S Lambright; James R Sheller; Joyce E Johnson; Robert F Miller |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: The New England journal of medicine Volume: 365 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2011 Jul |
Date Detail:
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Created Date: 2011-07-21 Completed Date: 2011-07-28 Revised Date: 2012-03-12 |
Medline Journal Info:
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Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States |
Other Details:
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Languages: eng Pagination: 222-30 Citation Subset: AIM; IM |
Affiliation:
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Division of Pulmonary and Critical Care Medicine, Meharry Medical College, Nashville, TN, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Afghan Campaign 2001- Bronchioles / pathology* Bronchiolitis Obliterans / pathology, physiopathology*, radiography Exercise Test Exercise Tolerance* Follow-Up Studies Humans Iraq War, 2003 - Lung / pathology, radiography Military Personnel* Prevalence Respiratory Function Tests Tomography, X-Ray Computed United States |
| Grant Support | |
ID/Acronym/Agency:
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UL1 RR024975-05/RR/NCRR NIH HHS; UL1-RR024975/RR/NCRR NIH HHS |
| Comments/Corrections | |
Comment In:
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N Engl J Med. 2011 Nov 3;365(18):1743; author reply 1744-5
[PMID:
22047574
]
N Engl J Med. 2011 Nov 3;365(18):1743-4; author reply 1744-5 [PMID: 22047575 ] N Engl J Med. 2011 Nov 3;365(18):1744; author reply 1744-5 [PMID: 22047576 ] |
Erratum In:
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N Engl J Med. 2011 Nov 3;365(18):1749 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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