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CME

Respiratory Bronchiolitis-associated Interstitial Lung Disease (RB-ILD)

General Information

Description

  • rare, smoking-related idiopathic interstitial pneumonia characterized by accumulation of macrophages in respiratory bronchioles and peribronchial interstitium1,2,3

Also called

  • respiratory bronchiolitis associated interstitial lung disease
  • RB-ILD

Definitions

  • respiratory bronchiolitis (RB) - common inflammatory condition of respiratory bronchioles in smokers (usually asymptomatic)1,3
  • RB-associated interstitial lung disease (RB-ILD) - rare, exaggerated RB with either more extensive peribronchiolar interstitial fibrosis or other clinical evidence of ILD1,3

Types

  • respiratory bronchiolitis interstitial lung disease is a type of idiopathic interstitial pneumonia
    • classification of idiopathic interstitial pneumonias based on multidisciplinary diagnoses
      • major types
        • chronic fibrosing interstitial pneumonia
          • idiopathic pulmonary fibrosis
          • idiopathic nonspecific interstitial pneumonia
        • smoking-related interstitial pneumonia
          • respiratory bronchiolitis-interstitial lung disease
          • desquamative interstitial pneumonia
        • acute/subacute interstitial pneumonia
          • cryptogenic organizing pneumonia
          • acute interstitial pneumonia (formerly Hamman-Rich syndrome)
      • rare types
        • idiopathic lymphocytic (lymphoid) interstitial pneumonia
        • idiopathic pleuroparenchymal fibroelastosis
      • unclassifiable interstitial lung disease
      • Reference - American Thoracic Society/European Respiratory Society update of the international multidisciplinary classification of the idiopathic interstitial pneumonias (24032382Am J Respir Crit Care Med 2013 Sep 15;188(6):733)

References

General references used

  1. Sieminska A, Kuziemski K. Respiratory bronchiolitis-interstitial lung disease. Orphanet J Rare Dis. 2014 Jul 11;9:106full-text
  2. Caminati A, Cavazza A, Sverzellati N, Harari S. An integrated approach in the diagnosis of smoking-related interstitial lung diseases. Eur Respir Rev. 2012 Sep 1;21(125):207-17full-text
  3. Bradley B, Branley HM, Egan JJ, et al; British Thoracic Society Interstitial Lung Disease Guideline Group, British Thoracic Society Standards of Care Committee, Thoracic Society of Australia, New Zealand Thoracic Society, Irish Thoracic Society. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax. 2008 Sep;63 Suppl 5:v1-58, correction can be found in Thorax 2008 Nov;63(11):1029, commentary can be found in Thorax 2009 Jun;64(6):548

Recommendation grading systems used

  • British Thoracic Society (BTS) grades of recommendations
    • Grade A recommendation - based on evidence from high-quality or well-conducted meta-analyses, systematic reviews, or randomized trials with a very low or low risk of bias, directly applicable to the target population and demonstrating overall consistency of results
    • Grade B recommendation - based on either
      • body of evidence including high-quality systematic reviews of case-control or cohort studies or high-quality case-control or cohort studies directly applicable to the target population and demonstrating overall consistency of results, or
      • extrapolated evidence from high-quality or well-conducted meta-analyses, systematic reviews, or randomized trials with a very low or low risk of bias
    • Grade C recommendation - based on either
      • evidence from well-conducted case-control or cohort studies directly applicable to the target population and demonstrating overall consistency of results, or
      • extrapolated evidence from high-quality systematic reviews of case-control or cohort studies or high-quality case-control or cohort studies
    • Grade D recommendation - based on either
      • evidence from case reports, case series, expert opinion, or
      • extrapolated from well-conducted case-control or cohort studies
    • Reference - BTS, Thoracic Society of Australia, New Zealand Thoracic Society, and Irish Thoracic Society guidelines on interstitial lung disease (18757459Thorax 2008 Sep;63 Suppl 5:v1), correction can be found in Thorax 2008 Nov;63(11):1029, multiple author names added, commentary can be found in 19478126Thorax 2009 Jun;64(6):548

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How to cite

National Library of Medicine, or "Vancouver style" (International Committee of Medical Journal Editors):

  • DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No. T918778, Respiratory Bronchiolitis-associated Interstitial Lung Disease (RB-ILD); [updated 2018 Nov 30, cited place cited date here]. Available from https://www.dynamed.com/topics/dmp~AN~T918778. Registration and login required.

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