A 60 year-old man and his two daughters, aged 29 and 26, were hospitalized due to dyspnea and productive cough which had been observed for several years. The diffuse disseminated small nodular shadows on chest X-ray film, obstructive disturbance in pulmonary function studies, hypoxemic respiratory failure and chronic sinusitis observed in these patients were clinically compatible with signs of diffuse panbronchiolitis. Diagnosis was confirmed histologically in the father and his elder daughter by transbronchial lung biopsy (TBLB). They live in small rural town with no special environmental or occupational hazard. These cases may be of some significance in relation to genetical or hereditary analyses of etiological factors of diffuse panbronchiolitis.
Additionally, abnormally high titers of cold agglutinin (more than ×1024) were observed in all these cases. Based on these results, we carried out a retrospective survey for this agglutinin in various lung diseases. While is true that patients of this disease frequently showed abnormally high cold agglutinin test titers is not specific for diffuse panbronchiolitis.
