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[Clinical characteristics of bronchiolitis obliterans in pediatric patients].
Zhonghua Er Ke Za Zhi 2012; 50(2):98-102ZE

Abstract

OBJECTIVE

To analyze the clinical characteristics, image findings, laboratory examination, the therapeutic methods and clinical outcomes of bronchiolitis obliterans (BO) in pediatric patients.

METHOD

Twenty-six pediatric patients with BO were reported. All data were collected from cases who were hospitalized in the Department of Pediatrics, First Affiliated Hospital of Guangzhou Medical College from June 1(st), 2009 to the April 30(th), 2011, and infectious agents, clinical manifestations, risk factors, changes in imageology, laboratory examination, therapeutic methods and treatment responses were analyzed.

RESULT

The ranges of age at onset was 4.5 months-8 years in 26 cases (18 boys and 8 girls). The course of disease was (6.2 ± 3.5) months. The period of followed-up ranged from 2 to 24 months. The common clinical characteristics were persistent wheezing of different severity (26 cases, 100%), cough (24 cases, 92%), intolerance to exercise (22 cases, 85%), short of breath (21 cases, 81%), retraction (20 cases, 77%), wheezy phlegm (16 cases, 62%), keeping with crackles (10 cases, 38%), cyanosis around the mouth (3 cases, 12%) and no clubbed fingers (toes). In 18 cases the etiology was detected, mycoplasma (11 cases, 42%), respiratory syncytial virus (4 cases, 15%), parainfluenza virus (2 cases, 8%), influenza virus A (2 cases, 8%) and influenza virus B (2 cases, 8%), human bocavirus (HBoV) (1 case, 4%). There were 8 cases (31%) with combined infection. Chest X-ray in 10 cases indicated changes suggestive of bronchopneumonia (38%), in only 1 case there was an image of interstitial pneumonia disease (4%). All the patients were diagnosed by high-resolution computerized tomography (HRCT). All cases were demonstrated to have air retention, poor blood perfusion in lung, just like "Westemark sign" with HRCT. In 19 cases antineutrophil cytoplasmic antibody (ANCA) was determined and 10 patients (53%) were positive for P-ANCA, and 8 cases (42%) were positive for C-ANCA. All patients received oral corticosteroid and low doses azithromycin. In 13 cases (50%) the treatment effectively reduced the severity of disease and the frequency of cough and wheezing. The average number of days for symptom improvement was (7.1 ± 4.8) days.

CONCLUSION

Respiratory infection plays an important role in BO in children. The chronic and persistent wheezing, cough, intolerance to exercises, short breath, retraction were the main clinical manifestations. But these symptoms are non-specific. Chest X-ray can not provide enough information for diagnosis. Classical "Westemark sign" with HRCT is an important sign. ANCA with a high positive rate (approximately 50%) suppose immuno-lesion in BO. Oral corticosteroid and methotrexate may relieve clinical symptoms.

Authors+Show Affiliations

Department of Pediatrics, the First Affiliated Hospital of Guangzhou Medical College, Guangzhou 510120, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

chi

PubMed ID

22455631

Citation

Chen, De-hui, et al. "[Clinical Characteristics of Bronchiolitis Obliterans in Pediatric Patients]." Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics, vol. 50, no. 2, 2012, pp. 98-102.
Chen DH, Lin YN, Lan SL, et al. [Clinical characteristics of bronchiolitis obliterans in pediatric patients]. Zhonghua Er Ke Za Zhi. 2012;50(2):98-102.
Chen, D. H., Lin, Y. N., Lan, S. L., Pan, X. A., Zeng, Q. S., He, Z. T., ... Zhong, N. S. (2012). [Clinical characteristics of bronchiolitis obliterans in pediatric patients]. Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics, 50(2), pp. 98-102.
Chen DH, et al. [Clinical Characteristics of Bronchiolitis Obliterans in Pediatric Patients]. Zhonghua Er Ke Za Zhi. 2012;50(2):98-102. PubMed PMID: 22455631.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical characteristics of bronchiolitis obliterans in pediatric patients]. AU - Chen,De-hui, AU - Lin,Yu-neng, AU - Lan,Shu-ling, AU - Pan,Xiao-an, AU - Zeng,Qing-si, AU - He,Zhen-tao, AU - Liang,Ming, AU - Zhang,Bi-yun, AU - Wu,Shang-zhi, AU - Xu,Jia-xing, AU - Gong,Xiao-yan, AU - Zhong,Nan-shan, PY - 2012/3/30/entrez PY - 2012/3/30/pubmed PY - 2013/3/5/medline SP - 98 EP - 102 JF - Zhonghua er ke za zhi = Chinese journal of pediatrics JO - Zhonghua Er Ke Za Zhi VL - 50 IS - 2 N2 - OBJECTIVE: To analyze the clinical characteristics, image findings, laboratory examination, the therapeutic methods and clinical outcomes of bronchiolitis obliterans (BO) in pediatric patients. METHOD: Twenty-six pediatric patients with BO were reported. All data were collected from cases who were hospitalized in the Department of Pediatrics, First Affiliated Hospital of Guangzhou Medical College from June 1(st), 2009 to the April 30(th), 2011, and infectious agents, clinical manifestations, risk factors, changes in imageology, laboratory examination, therapeutic methods and treatment responses were analyzed. RESULT: The ranges of age at onset was 4.5 months-8 years in 26 cases (18 boys and 8 girls). The course of disease was (6.2 ± 3.5) months. The period of followed-up ranged from 2 to 24 months. The common clinical characteristics were persistent wheezing of different severity (26 cases, 100%), cough (24 cases, 92%), intolerance to exercise (22 cases, 85%), short of breath (21 cases, 81%), retraction (20 cases, 77%), wheezy phlegm (16 cases, 62%), keeping with crackles (10 cases, 38%), cyanosis around the mouth (3 cases, 12%) and no clubbed fingers (toes). In 18 cases the etiology was detected, mycoplasma (11 cases, 42%), respiratory syncytial virus (4 cases, 15%), parainfluenza virus (2 cases, 8%), influenza virus A (2 cases, 8%) and influenza virus B (2 cases, 8%), human bocavirus (HBoV) (1 case, 4%). There were 8 cases (31%) with combined infection. Chest X-ray in 10 cases indicated changes suggestive of bronchopneumonia (38%), in only 1 case there was an image of interstitial pneumonia disease (4%). All the patients were diagnosed by high-resolution computerized tomography (HRCT). All cases were demonstrated to have air retention, poor blood perfusion in lung, just like "Westemark sign" with HRCT. In 19 cases antineutrophil cytoplasmic antibody (ANCA) was determined and 10 patients (53%) were positive for P-ANCA, and 8 cases (42%) were positive for C-ANCA. All patients received oral corticosteroid and low doses azithromycin. In 13 cases (50%) the treatment effectively reduced the severity of disease and the frequency of cough and wheezing. The average number of days for symptom improvement was (7.1 ± 4.8) days. CONCLUSION: Respiratory infection plays an important role in BO in children. The chronic and persistent wheezing, cough, intolerance to exercises, short breath, retraction were the main clinical manifestations. But these symptoms are non-specific. Chest X-ray can not provide enough information for diagnosis. Classical "Westemark sign" with HRCT is an important sign. ANCA with a high positive rate (approximately 50%) suppose immuno-lesion in BO. Oral corticosteroid and methotrexate may relieve clinical symptoms. SN - 0578-1310 UR - https://www.unboundmedicine.com/medline/citation/22455631/[Clinical_characteristics_of_bronchiolitis_obliterans_in_pediatric_patients]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&issn=0578-1310&year=2012&vol=50&issue=2&fpage=98 DB - PRIME DP - Unbound Medicine ER -