SESSION TYPE: Diagnostic Bronchoscopy
PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM
PURPOSE: Tracheobronchopathia Osteochondroplastica (TBPOCP), has been depicted as a rare disease with an elusive pathology. Given the paucity of published data on the natural history of the disease, there was a compelling need for further elucidation of its underlying demographic trends, clinical features, diagnostic and histological findings, and treatment approaches. In response, an extensive search of the literature was performed.
METHODS: 98 case reports involving 331 cases of TBPOCP, from 1947 through 2012, were identified via MEDLINE and EMBASE. Variables including patient data, disease presentation, diagnostic modalities and treatment approaches were extracted. Multivariate regression was employed to explore relationships of interest.
RESULTS: TBPOCP affects predominantly middle-aged males. The most common disease manifestation involves recurrent cough, generally lasting for several months. Of note, those presenting with hemoptysis were less likely to see disease progression than those presenting with dyspnea or stridor. The majority of afflicted patients are non-smokers and there doesn’t appear to be any hereditary component. The most common predisposing risk factor is asthma or chronic obstructive pulmonary disease (COPD) - no association with infectious process, prior malignancy or autoimmune disease was evident. Of note, individuals presenting with TBPOCP as well as COPD/asthma are more likely to see disease stabilization with surgical treatment of TBCOP than those TBPOCP patients without COPD/asthma (suggesting TBPOCP may not be caused by COPD/asthma - rather, it may actually be causing a form of obstructive pulmonary disease). Multivariate linear regression indicates nodular size is inversely correlated with %FEV. Multivariate logistic regression indicates disease resolution is positively correlated with age and whether the patient has underlying risk factors for TBPOCP that are modifiable or preventable.
CONCLUSIONS: The above findings serve to further augment our understanding of this complex disease and help improve our diagnostic and treatment capabilities.
CLINICAL IMPLICATIONS: This is the first study to rigorously define the underlying patient population of TBPOCP as well as identify the potential risk factors associated with TBPOCP presentation and progression.
DISCLOSURE: The following authors have nothing to disclose: Abubakr Chaudhry, Elie Donath, Atul Mehta
No Product/Research Disclosure InformationUniversity of Miami Miller School of Medicine, Palm Beach Regional Campus, West Palm Beach, FL