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Bronchiolitis obliterans syndrome
What's new
Updated 2024 ATS guidelines for the diagnosis of bronchiolitis obliterans syndrome after pediatric hematopoietic stem cell transplantation .
Background
Overview
Definition
BOS is a form of chronic lung allograft dysfunction characterized by progressive airflow obstruction in the absence of acute rejection, infection, or other coexistent conditions.
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Pathophysiology
BOS is caused by immune-mediated injury (alloimmune T-cell reactivity, humoral immunity, autoimmunity, pulmonary innate immunity) and environmental insults.
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Disease course
BOS manifests as progressive dyspnea and cough, with imaging features of constrictive bronchiolitis, airway distortion, and subepithelial fibrosis.
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Prognosis and risk of recurrence
Severe BOS is associated with a mortality of 66.6%.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of bronchiolitis obliterans syndrome are prepared by our editorial team based on guidelines from the American Thoracic Society (ATS 2024), the European Respiratory Society (ERS/EBMT 2024), the British Thoracic Society (BTS 2020), and the European Respiratory Society (ERS/ATS/ISHLT 2014).
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