Chronic Bronchitis

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Chronic Bronchitis

  1. 1. SHAHD ALALI CHRONIC BRONCHITIS
  2. 2. • It is characterized by a chronic productive cough lasting at least 3 months over a minimum of 2 years. • Common among smokers • Most have both emphysema & chronic bronchitis • Early stages of the disease: • Productive cough • Mucoid sputum
  3. 3. ETIOLOGY • Smoking • Air pollutants • Sulfur dioxide • Nitrogen dioxide • Cystic fibrosis • Coexistent emphysema • Experimental evidence: Increase transcription of mucin gene
  4. 4. PATHOGENESIS • Charactirized by hypertrophy of bronchial mucinous glands thus hypersecretion of mucus • Increased thickness of mucus glands (Reid index increases to >50%) • Casing inflammation (CD8+, lymphocytes…. • In contrast with asthma there are no eosinophils • Microbial infection often is present
  5. 5. MORPHOLOGY • Large airways gross specimens: • Hyperemic • Swollen by edema fluid • Covered by a layer of mucinous secretion • Increase of goblet cells • Histological examination of trachea & bronchi: • Enlargement of mucus-secreting glands • Inflammatory cells (mononuclear / mixed with neutrophils)
  6. 6. • Chronic bronchiolitis: • Goblet cell metaplasia • Mucous plugging • Inflammation • Fibrosis
  7. 7. CLINICAL FEATURES • Prominent cough & production of sputum • Cyanosis “Blue bloaters” • Increase risk of infection • Tend to be stocky or obese • Wheezing • Hypoxemia • Dyspnea
  8. 8. PULMONARY FUNCTION TEST • Less increased TLC & RV than emphysema • Chronic respiratory acidosis
  9. 9. COMPLICATIONS • Respiratory failure • Cor pulmonale

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