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Respiratory Diseases
An overview of conditions affecting the lungs and airways, covering causes, symptoms, disease processes, diagnostic methods, treatment approaches and prognosis.
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An overview of conditions affecting the lungs and airways, covering causes, symptoms, disease processes, diagnostic methods, treatment approaches and prognosis.
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141records
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| # | TextNo. | TextDisease Name | TextCategory | TextPrimary Cause / Etiology | TextPrevalence | TextAge of Onset | TextKey Symptoms | TextAffected Respiratory Structure | TextDiagnostic Method | TextTreatment Approach | TextPrognosis | TextICD-10 Code |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 01 | 1 | Allergic Bronchopulmonary Aspergillosis (ABPA) | Obstructive Airway Diseases | Hypersensitivity to Aspergillus fumigatus colonizing airways; Th2-driven IgE response; occurs in asthma (1-2%) and CF (7-9%); mucoid impaction and bronchial damage | Affects 1-2% of asthmatics and 7-9% of CF patients; geographic variation; more common in tropical regions | Usually 20-40 years; in CF patients, adolescence to young adulthood | Worsening asthma, recurrent pulmonary infiltrates, productive cough with brown mucus plugs, hemoptysis, fever during exacerbations, progressive bronchiectasis | Proximal (central) bronchiectasis pathognomonic; mucoid impaction with eosinophilic mucin containing fungal hyphae; airway destruction over time | Elevated total IgE >1000 IU/mL; positive Aspergillus skin test or specific IgE; serum precipitins; blood eosinophilia >500; CT showing central bronchiectasis and mucoid impaction; Rosenberg criteria | Oral prednisone 0.5mg/kg for 2 weeks then taper over 3-5 months; itraconazole 200mg BID for 4-6 months (reduces steroid need); omalizumab for refractory cases; monitoring total IgE for relapse | Chronic relapsing course; 5 stages from acute to fibrotic; early treatment preserves lung function; fibrotic stage (Stage V) irreversible; long-term monitoring of IgE levels essential | B44.81 |
| 02 | 2 | Alpha-1 Antitrypsin Deficiency Emphysema | Obstructive Airway Diseases | Genetic deficiency of alpha-1 antitrypsin (SERPINA1 gene); ZZ phenotype most severe; uninhibited neutrophil elastase destroys alveoli; smoking dramatically accelerates disease | 1 in 2,500-5,000 of European descent; only 5-10% diagnosed; accounts for 1-3% of COPD | 30-50 years (earlier if smoking); panlobular emphysema predominantly basal | Progressive dyspnea, wheezing, reduced exercise capacity; lower lobe predominant emphysema (unlike smoking-related); hepatic disease in 10-15%; panniculitis rare | Panlobular emphysema predominantly lower lobes; hepatic inclusions of polymerized AAT; accelerated FEV1 decline | Serum AAT level <11 μmol/L (57 mg/dL); Pi typing or SERPINA1 genotyping; CT chest showing basal emphysema; spirometry; liver function tests | IV augmentation therapy (Prolastin, Zemaira) 60mg/kg weekly; standard COPD treatment; smoking cessation critical; lung transplant for severe disease; liver transplant if needed | Without augmentation: FEV1 decline 70-100ml/year; with augmentation: decline reduced to 40-50ml/year; never-smokers have better prognosis; median survival 60+ years if never-smoked | E88.01 |
| 03 | 3 | Asthma (Allergic) | Obstructive Airway Diseases | Type I IgE-mediated hypersensitivity; genetic predisposition (ADAM33, ORMDL3); aeroallergens (dust mites, pollen, pet dander); atopic triad | 339 million worldwide; 8-10% of adults; prevalence rising in developed nations | Childhood onset typical (80% before age 6); can present at any age | Episodic wheezing, dyspnea, chest tightness, cough (worse at night); triggered by allergens, exercise, cold air; symptom-free intervals | Bronchial smooth muscle hyperresponsiveness; eosinophilic airway inflammation; mucous hypersecretion; reversible airflow obstruction | Spirometry with reversibility (FEV1 >12% and 200ml post-BD); methacholine challenge; FeNO >25ppb; skin prick testing; serum IgE and eosinophils | ICS (fluticasone, budesonide) cornerstone; SABA PRN (salbutamol); LABA add-on (formoterol); LTRA (montelukast); biologics for severe: omalizumab (anti-IgE), mepolizumab (anti-IL5), dupilumab (anti-IL4R) | Excellent prognosis with treatment; mortality <1% with proper management; 30-50% of children outgrow symptoms; uncontrolled asthma increases airway remodeling risk | J45.20 |
| 04 | 4 | Asthma (Non-Allergic/Intrinsic) | Obstructive Airway Diseases | Non-IgE-mediated; triggers include infections, exercise, cold air, irritants, stress, GERD, hormonal changes; neutrophilic airway inflammation predominant | 10-33% of all asthma cases; more common in adults; F:M 2:1 | Adult onset typical (>30 years); often more severe than allergic asthma | Persistent dyspnea, cough, wheezing; less episodic than allergic asthma; poor response to allergen avoidance; often associated with nasal polyps and aspirin sensitivity | Neutrophilic or pauci-granulocytic airway inflammation; airway remodeling more pronounced; subepithelial fibrosis | Spirometry with reversibility; negative skin prick tests and normal IgE; FeNO often normal; CT sinuses for polyps; aspirin challenge if suspected | Higher-dose ICS often required; LABA/ICS combination; tiotropium add-on; macrolide therapy (azithromycin) for neutrophilic; anti-IL5 biologics; aspirin desensitization if AERD | More persistent symptoms; less responsive to ICS; greater decline in lung function; 5-year remission rate lower (10%) vs allergic asthma (25%) | J45.30 |
| 05 | 5 | Bronchiectasis (Non-Cystic Fibrosis) | Obstructive Airway Diseases | Post-infectious (TB, pneumonia); immune deficiency (CVID, IgA deficiency); ciliary dyskinesia; ABPA; autoimmune (RA, IBD); idiopathic in 30-50% | Prevalence 350-566 per 100,000 in >65 years; increasing with CT availability; F:M 1.5:1 | Any age; post-infectious forms often childhood onset; idiopathic peaks at 60-70 years | Chronic productive cough with copious purulent sputum, recurrent respiratory infections, hemoptysis (50-70%), dyspnea, fatigue, rhinosinusitis | Permanent bronchial dilation; vicious cycle of infection, inflammation, and structural damage; typically lower lobe predominant | HRCT chest (gold standard): bronchial dilation, signet ring sign, lack of tapering; sputum culture; immunoglobulin levels; CF screening; ciliary function tests | Airway clearance techniques; long-term macrolides (azithromycin 250mg 3x/week); inhaled antibiotics (tobramycin, colistin) for Pseudomonas; mucolytics; bronchodilators; surgical resection for localized disease | Chronic progressive condition; Pseudomonas colonization worsens prognosis; annual FEV1 decline 50-55ml; 5-year mortality 10-16%; frequent exacerbations predict worse outcomes | J47.9 |
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