Sauropus androgynus-associated bronchiolitis obliterans of mother and daughter – autopsy report

Abstract

Sauropus androgynus (SA) is a vegetable that causes constrictive bronchiolitis obliterans (BO) with consequent findings classified into injury, inflammation and fibrosis, according to clinical factors including amount of SA exposure, period of SA exposure, and individual predisposition. We reported mother and daughter SABO autopsy cases with similar clinical course, including 11 month SA exposure and Aspergillosis infection after high dose prednisolone therapy. Their major differences were in the amount of SA exposure (mother: 1440 g, daughter: 2190 g) and the survival period post exposure (mother: 21 months, daughter: 32 months). The histopathological comparison between them showed a statistical difference in the density of foamy macrophage accumulation of moderately obstructed airways, but not in the extent of fibrosis, elastic lamina destruction, or smooth muscle hyperplasia. Foamy macrophages tend to accumulate relatively early in the course of SABO at the site with severe damage, accelerating BO formation for as long as the patient survives.