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[Clinical analysis of 28 cases of bronchiolitis obliterans].
Zhongguo Dang Dai Er Ke Za Zhi 2013; 15(10):845-9ZD

Abstract

OBJECTIVE

To study the clinical features of bronchiolitis obliterans (BO) in children.

METHODS

The clinical data of 28 children with BO between July 2007 and April 2012 was retrospectively reviewed.

RESULTS

All patients presented with persistent or repeated cough and wheezing. Twenty-three cases were post-infectious bronchiolitis obliterans (PIBO), among whom the etiology were adenovirus (12 cases), measles (2 cases), influenza virus A (2 cases), mycoplasma pneumoniae (1 case), mycoplasma pneumoniae coinfection with adenovirus (1 case), respiratory syncytial virus coinfection with Parainfluenza type 3 virus (1 case) and pulmonary tuberculosis (1 case). The etiology of 3 cases was not associated with infection. The etiology was unknown in 2 cases. Pulmonary HRCT revealed that decreased density in 25 cases, mosaic perfusion in 21 cases, bronchial wall thickening in 15 cases, bronchiectasis in 12 cases and air retention in 6 cases. Lung function test was performed on 21 cases and demonstrated that obstructive ventilation disorder in all 21 cases. Bronchodilation test was performed on 18 cases and 17 cases showed a negative result. All 28 cases received corticosteroid treatment, and 24 cases were orally administered with low doses of azithromycin. One case died during hospitalization. Eighteen cases were followed up for 4 months to 4 years and seven months. Clinical manifestations were improved in 12 cases and one case died.

CONCLUSIONS

Low respiratory infection is the most common cause of pediatric BO and adenovirus is a major pathogen. Persistent wheezing and cough were main clinical manifestations. Pulmonary HRCT imaging is important for diagnosis and follow-up of BO. Lung function test can typically show obstructive ventilation disorder. Corticosteroid and methotrexate may be effective for treatment of BO. Prognosis of this disease is unsatisfactory. Early diagnosis and treatment, and avoidance of repeated respiratory tract infection may be helpful to improve the prognosis.

Authors+Show Affiliations

Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China. luozhengxiu816@163.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

24131836

Citation

Wu, Xiao-Ying, et al. "[Clinical Analysis of 28 Cases of Bronchiolitis Obliterans]." Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics, vol. 15, no. 10, 2013, pp. 845-9.
Wu XY, Luo ZX, Fu Z, et al. [Clinical analysis of 28 cases of bronchiolitis obliterans]. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15(10):845-9.
Wu, X. Y., Luo, Z. X., Fu, Z., Liu, E. M., Luo, J., & He, L. (2013). [Clinical analysis of 28 cases of bronchiolitis obliterans]. Zhongguo Dang Dai Er Ke Za Zhi = Chinese Journal of Contemporary Pediatrics, 15(10), pp. 845-9.
Wu XY, et al. [Clinical Analysis of 28 Cases of Bronchiolitis Obliterans]. Zhongguo Dang Dai Er Ke Za Zhi. 2013;15(10):845-9. PubMed PMID: 24131836.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Clinical analysis of 28 cases of bronchiolitis obliterans]. AU - Wu,Xiao-Ying, AU - Luo,Zheng-Xiu, AU - Fu,Zhou, AU - Liu,En-Mei, AU - Luo,Jian, AU - He,Ling, PY - 2013/10/18/entrez PY - 2013/10/18/pubmed PY - 2014/4/25/medline SP - 845 EP - 9 JF - Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics JO - Zhongguo Dang Dai Er Ke Za Zhi VL - 15 IS - 10 N2 - OBJECTIVE: To study the clinical features of bronchiolitis obliterans (BO) in children. METHODS: The clinical data of 28 children with BO between July 2007 and April 2012 was retrospectively reviewed. RESULTS: All patients presented with persistent or repeated cough and wheezing. Twenty-three cases were post-infectious bronchiolitis obliterans (PIBO), among whom the etiology were adenovirus (12 cases), measles (2 cases), influenza virus A (2 cases), mycoplasma pneumoniae (1 case), mycoplasma pneumoniae coinfection with adenovirus (1 case), respiratory syncytial virus coinfection with Parainfluenza type 3 virus (1 case) and pulmonary tuberculosis (1 case). The etiology of 3 cases was not associated with infection. The etiology was unknown in 2 cases. Pulmonary HRCT revealed that decreased density in 25 cases, mosaic perfusion in 21 cases, bronchial wall thickening in 15 cases, bronchiectasis in 12 cases and air retention in 6 cases. Lung function test was performed on 21 cases and demonstrated that obstructive ventilation disorder in all 21 cases. Bronchodilation test was performed on 18 cases and 17 cases showed a negative result. All 28 cases received corticosteroid treatment, and 24 cases were orally administered with low doses of azithromycin. One case died during hospitalization. Eighteen cases were followed up for 4 months to 4 years and seven months. Clinical manifestations were improved in 12 cases and one case died. CONCLUSIONS: Low respiratory infection is the most common cause of pediatric BO and adenovirus is a major pathogen. Persistent wheezing and cough were main clinical manifestations. Pulmonary HRCT imaging is important for diagnosis and follow-up of BO. Lung function test can typically show obstructive ventilation disorder. Corticosteroid and methotrexate may be effective for treatment of BO. Prognosis of this disease is unsatisfactory. Early diagnosis and treatment, and avoidance of repeated respiratory tract infection may be helpful to improve the prognosis. SN - 1008-8830 UR - https://www.unboundmedicine.com/medline/citation/24131836/[Clinical_analysis_of_28_cases_of_bronchiolitis_obliterans]_ L2 - http://www.zgddek.com/EN/abstract/abstract13182.shtml DB - PRIME DP - Unbound Medicine ER -