Abstract
English:
Obliterative bronchiolitis is a rare and complex obstructive pulmonary disorder involving inflammatory and fibroproliferative changes of the small airways. We report three adult cases of idiopathic bronchiolitis obliterans diagnosed at the “Marius Nasta” Institute of Pulmonology, Bucharest, between 2016 and 2025. The patients, aged 30–68 years, presented with exertional dyspnoea and fatigue, and all exhibited severe obstructive ventilatory impairment with significant oxygen desaturation during the 6-min walk test. Diagnosis was confirmed by high-resolution inspiratory–expiratory computed tomography in two cases and by lung biopsy in one case. Treatment consisted of systemic and inhaled corticosteroids, with one patient also receiving longterm intermittent azithromycin therapy. Outcomes varied: two patients achieved relative clinical stability, while one experienced progressive respiratory decline leading to death. These cases illustrate the diagnostic and therapeutic challenges of idiopathic bronchiolitis obliterans and highlight its unpredictable course. Early recognition and individualised management are essential, but further research is needed to establish effective treatment strategies and improve prognosis.