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Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment.
Exp Ther Med 2015; 9(6):2379-2383ET

Abstract

The aim of the present study was to outline any predisposing factors and clinical and radiological features of post-infectious bronchiolitis obliterans (PIBO) in pediatric patients, and to determine the effect of long-term azithromycin treatment on these factors. In total, 16 cases of children with PIBO were retrospectively reviewed. Adenovirus and Mycoplasma pneumoniae were the most common etiological agents (12/16) in the children with PIBO. The patients presented with persistent dyspnea, a chronic cough, sputum production and wheezing following the initial lung infection. Chest X-rays indicated pulmonary overinflation and patchy ground-glass opacity. In addition, high-resolution computed tomography (HRCT) scans revealed patchy ground-glass opacity, bronchiectasis, bronchial wall thickening and mosaic perfusion in all 16 cases. A unilateral hyperlucent lung was observed in two cases. All the patients underwent treatment with low-dose azithromycin and prednisone. Follow-up examinations of the 16 cases, varying in duration between 7 and 31 months, showed that the disease condition had improved in 10 cases. However, no significant improvements were identified from the HRCT scans or were observed in the patient condition in the additional six cases. The diagnosis of BO is primarily based on a typical clinical presentation and HRCT observations. Therefore, a typical clinical history and patchy ground-glass opacity features on HRCT scans are screening indices that predict BO development. Steroids are the cornerstone of BO treatment; however, long-term azithromycin treatment can improve the condition of the patients. In summary, PIBO is a disease with a high morbidity rate and should be treated by a multidisciplinary team. Patients should receive follow-up examination for an extended period. Patchy ground-glass opacity features on HRCT scans indicate that clinical suspicion of BO is necessary in children with persistent and severe wheezing.

Authors+Show Affiliations

Department of Pediatrics, The Second Hospital of Tianjin Medical University, Heping, Tianjin 300211, P.R. China.Department of Pediatrics, The Second Hospital of Tianjin Medical University, Heping, Tianjin 300211, P.R. China.Department of Pediatrics, The Second Hospital of Tianjin Medical University, Heping, Tianjin 300211, P.R. China.Department of Pediatrics, The Second Hospital of Tianjin Medical University, Heping, Tianjin 300211, P.R. China.Department of Radiology, The Second Hospital of Tianjin Medical University, Heping, Tianjin 300211, P.R. China.Department of Pediatrics, The General Hospital of Tianjin Medical University, Heping, Tianjin 300052, P.R. China.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26136991

Citation

Wang, Xueyan, et al. "Clinical Features of Post-infectious Bronchiolitis Obliterans in Children Undergoing Long-term Azithromycin Treatment." Experimental and Therapeutic Medicine, vol. 9, no. 6, 2015, pp. 2379-2383.
Wang X, Liu C, Wang M, et al. Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment. Exp Ther Med. 2015;9(6):2379-2383.
Wang, X., Liu, C., Wang, M., Zhang, Y. I., Li, H., & Liu, G. (2015). Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment. Experimental and Therapeutic Medicine, 9(6), pp. 2379-2383.
Wang X, et al. Clinical Features of Post-infectious Bronchiolitis Obliterans in Children Undergoing Long-term Azithromycin Treatment. Exp Ther Med. 2015;9(6):2379-2383. PubMed PMID: 26136991.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment. AU - Wang,Xueyan, AU - Liu,Changshan, AU - Wang,Mengjuan, AU - Zhang,Y I, AU - Li,Hewen, AU - Liu,Geli, Y1 - 2015/04/08/ PY - 2014/09/26/received PY - 2015/03/05/accepted PY - 2015/7/3/entrez PY - 2015/7/3/pubmed PY - 2015/7/3/medline KW - azithromycin KW - child KW - post-infectious bronchiolitis obliterans KW - steroids SP - 2379 EP - 2383 JF - Experimental and therapeutic medicine JO - Exp Ther Med VL - 9 IS - 6 N2 - The aim of the present study was to outline any predisposing factors and clinical and radiological features of post-infectious bronchiolitis obliterans (PIBO) in pediatric patients, and to determine the effect of long-term azithromycin treatment on these factors. In total, 16 cases of children with PIBO were retrospectively reviewed. Adenovirus and Mycoplasma pneumoniae were the most common etiological agents (12/16) in the children with PIBO. The patients presented with persistent dyspnea, a chronic cough, sputum production and wheezing following the initial lung infection. Chest X-rays indicated pulmonary overinflation and patchy ground-glass opacity. In addition, high-resolution computed tomography (HRCT) scans revealed patchy ground-glass opacity, bronchiectasis, bronchial wall thickening and mosaic perfusion in all 16 cases. A unilateral hyperlucent lung was observed in two cases. All the patients underwent treatment with low-dose azithromycin and prednisone. Follow-up examinations of the 16 cases, varying in duration between 7 and 31 months, showed that the disease condition had improved in 10 cases. However, no significant improvements were identified from the HRCT scans or were observed in the patient condition in the additional six cases. The diagnosis of BO is primarily based on a typical clinical presentation and HRCT observations. Therefore, a typical clinical history and patchy ground-glass opacity features on HRCT scans are screening indices that predict BO development. Steroids are the cornerstone of BO treatment; however, long-term azithromycin treatment can improve the condition of the patients. In summary, PIBO is a disease with a high morbidity rate and should be treated by a multidisciplinary team. Patients should receive follow-up examination for an extended period. Patchy ground-glass opacity features on HRCT scans indicate that clinical suspicion of BO is necessary in children with persistent and severe wheezing. SN - 1792-0981 UR - https://www.unboundmedicine.com/medline/citation/26136991/Clinical_features_of_post_infectious_bronchiolitis_obliterans_in_children_undergoing_long_term_azithromycin_treatment_ L2 - https://www.ingentaconnect.com/openurl?genre=article&issn=1792-0981&volume=9&issue=6&spage=2379&aulast=Wang DB - PRIME DP - Unbound Medicine ER -