[A case of constrictive bronchiolitis].

A 31-year-old woman was admitted to our hospital because of a dry cough and progressive exertional dyspnea after her second delivery. She had almost normal laboratory data except for an elevated value for antibody for nucleic acid, and her chest radiograph was normal. However, pulmonary function tests revealed a mixed pattern of dysfunction, and chest CT revealed a mosaic perfusion pattern. The VATS lung biopsy demonstrated complete occlusion of the membranous bronchiole. These results led to a diagnosis of constrictive bronchiolitis (CB). The patient and her family rejected the option of lung transplantation, and selected immunosuppressive therapy (steroid pulse therapy and cyclophosphamide pulse therapy). Her condition improved temporarily, but her respiratory condition worsened progressively, and finally she died one and a half years after the appearance of the symptoms. Although steroid pulse therapy and cyclophosphamide pulse therapy failed to cure the CB, they did retard its progression.