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Bronchiolitis obliterans in the 1990s in Korea and the United States.
Chest. 2001 Oct; 120(4):1101-6.Chest

Abstract

STUDY OBJECTIVES

Our current knowledge of pediatric bronchiolitis obliterans (BO) is based largely on a few small series of patients that were reported in the older literature. In these older cases, the mortality rate was high. This study was conducted to investigate the characteristics of pediatric BO cases in two different countries.

DESIGN

We extracted specific information regarding predisposing factors, symptoms and signs, diagnostic studies, treatment, and outcome from the medical records of 31 children who received diagnoses of BO at four university medical centers in Korea and the United States in the 1990s.

RESULTS

The large number of Asian children reflects a clustering of cases in Korea due to adenovirus and Mycoplasma pneumoniae epidemics. The characteristic diagnostic features of BO were present in 29 of 30 high-resolution CT (HRCT) studies. Seven of nine children who underwent biopsies had histologic confirmations of BO. In two patients whose biopsy results were nondiagnostic, the diagnosis was established by HRCT together with pulmonary function testing results that were consistent with nonreversible small airways obstruction. Fifteen children (48.4%) had evidence of hypoxemia. At present, all but one are alive. Patients with elevated severity-of-illness scores were observed to have increased likelihoods of lung transplantation or death.

CONCLUSIONS

We conclude that BO has a good overall prognosis and that the mortality rate has declined over the past decade. This could be related primarily to the use of HRCT for accurate diagnosis and the availability of pediatric lung transplantation. BO cases in Korea were associated with infectious epidemics, whereas those in United States had variable predisposing factors.

Authors+Show Affiliations

Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11591545

Citation

Kim, C K., et al. "Bronchiolitis Obliterans in the 1990s in Korea and the United States." Chest, vol. 120, no. 4, 2001, pp. 1101-6.
Kim CK, Kim SW, Kim JS, et al. Bronchiolitis obliterans in the 1990s in Korea and the United States. Chest. 2001;120(4):1101-6.
Kim, C. K., Kim, S. W., Kim, J. S., Koh, Y. Y., Cohen, A. H., Deterding, R. R., & White, C. W. (2001). Bronchiolitis obliterans in the 1990s in Korea and the United States. Chest, 120(4), 1101-6.
Kim CK, et al. Bronchiolitis Obliterans in the 1990s in Korea and the United States. Chest. 2001;120(4):1101-6. PubMed PMID: 11591545.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bronchiolitis obliterans in the 1990s in Korea and the United States. AU - Kim,C K, AU - Kim,S W, AU - Kim,J S, AU - Koh,Y Y, AU - Cohen,A H, AU - Deterding,R R, AU - White,C W, PY - 2001/10/10/pubmed PY - 2002/1/5/medline PY - 2001/10/10/entrez SP - 1101 EP - 6 JF - Chest JO - Chest VL - 120 IS - 4 N2 - STUDY OBJECTIVES: Our current knowledge of pediatric bronchiolitis obliterans (BO) is based largely on a few small series of patients that were reported in the older literature. In these older cases, the mortality rate was high. This study was conducted to investigate the characteristics of pediatric BO cases in two different countries. DESIGN: We extracted specific information regarding predisposing factors, symptoms and signs, diagnostic studies, treatment, and outcome from the medical records of 31 children who received diagnoses of BO at four university medical centers in Korea and the United States in the 1990s. RESULTS: The large number of Asian children reflects a clustering of cases in Korea due to adenovirus and Mycoplasma pneumoniae epidemics. The characteristic diagnostic features of BO were present in 29 of 30 high-resolution CT (HRCT) studies. Seven of nine children who underwent biopsies had histologic confirmations of BO. In two patients whose biopsy results were nondiagnostic, the diagnosis was established by HRCT together with pulmonary function testing results that were consistent with nonreversible small airways obstruction. Fifteen children (48.4%) had evidence of hypoxemia. At present, all but one are alive. Patients with elevated severity-of-illness scores were observed to have increased likelihoods of lung transplantation or death. CONCLUSIONS: We conclude that BO has a good overall prognosis and that the mortality rate has declined over the past decade. This could be related primarily to the use of HRCT for accurate diagnosis and the availability of pediatric lung transplantation. BO cases in Korea were associated with infectious epidemics, whereas those in United States had variable predisposing factors. SN - 0012-3692 UR - https://www.unboundmedicine.com/medline/citation/11591545/Bronchiolitis_obliterans_in_the_1990s_in_Korea_and_the_United_States_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0012-3692(16)35510-6 DB - PRIME DP - Unbound Medicine ER -