[Analysis of cases allowed to cease erythromycin therapy for diffuse panbronchiolitis--comparative study between patients with cessation of the therapy and patients continuing the therapy]

Abstract

We investigated the effect of erythromycin (EM) in patients with diffuse panbronchiolitis (DPB) who were divided into 2 groups, the short term group with 8 patients who were treated for at least 2 years and the long term group with 7 patients who were treated for more than 3 years. Each mean value of %VC, FEV1.0, FEV1.0% and PaO2 two years after administration to these patients was improved than before administration of EM, with the exception of PaO2 in the long term group. There was no change in %VC, FEV1.0, FEV1.0% or PaO2 in each group between one year after the therapy and thereafter, with the exception of the fact that FEV1.0% in the short term group, except patients restarting EM therapy, 2 years after the therapy was significantly higher than in the long term group. One patient was readministered EM because of recurrence of DPB after cessation of EM therapy, whose %VC, FEV1.0 and PaO2, but not FEV1.0%, one year after the therapy were increased in those before the therapy. The Neutrophil proportion in the bronchoalveolar lavage (BAL) fluid in this patient was still high after the therapy (94.5%), while that in the patients with cessation of the therapy was improved to the level of less than 8%. Neutrophil proportion in BAL fluids in the patients with continuation of the therapy revealed a high or low level after the therapy. These results suggest that the patients, whose %VC, FEB1.0% and PaO2 were improved and whose proportion of neutrophils in BAL fluid reduced to a normal level compared with those before EM therapy, can be allowed to cease therapy after 2 years or more of EM therapy.