Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China
Bronchiolitis obliterans (BO) is in general a rare and life-threatening form of non-reversible obstructive lung disease in which the bronchioles are compressed and narrowed by fibrosis and/or inflammation. The purpose of this study was to evaluate the clinical features of BO in pediatric patients an...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2017-12-01
|
| Series: | European Journal of Inflammation |
| Online Access: | https://doi.org/10.1177/1721727X17733392 |
| _version_ | 1819224939793743872 |
|---|---|
| author | Li Huang Yaping Xie Huifeng Fan Gen Lu Jialu Yu Chen Chen Diyuan Yang |
| author_facet | Li Huang Yaping Xie Huifeng Fan Gen Lu Jialu Yu Chen Chen Diyuan Yang |
| author_sort | Li Huang |
| collection | DOAJ |
| description | Bronchiolitis obliterans (BO) is in general a rare and life-threatening form of non-reversible obstructive lung disease in which the bronchioles are compressed and narrowed by fibrosis and/or inflammation. The purpose of this study was to evaluate the clinical features of BO in pediatric patients and explore its risk factors. The medical records of 35 pediatric patients with BO at Guangzhou Women and Children’s Medical Center were evaluated. The age at onset of symptoms was 2–42 months (mean 13.3 ± 8.9 months), with age at diagnosis of 5 months–4 years (mean 17.8 ± 9.0 months). High-resolution computed tomography findings included mosaic pattern (100%), atelectasis (37.1%), air trapping (31.4%), and bronchiectasis (20.0%). Three patients received lung biopsies and mainly exhibited an inflammatory process surrounding the lumen of bronchioles. BO predominantly resulted from post-infectious causes (91.4%) which were primarily caused by adenovirus (50%), followed by Mycoplasma pneumoniae (46.7%) and influenza (20%). Pulmonary function tests (PFTs) showed severe and fixed airflow obstruction, decreased compliance, and increased resistance. No significant difference was found between before and after steroid treatment ( P > 0.05). Two patients died owing to severe pulmonary complications, one of whom had inherent immunodeficiency. Our study suggests that the occurrence of BO, especially post-infectious BO, in China is relatively high and might result from primary immunodeficiency diseases in severe cases. Recurrent aspiration pneumonia caused by congenital dysplasia of the larynx and vaccination not on schedule might be potential risk factors for persistent and recurrent BO. |
| first_indexed | 2024-12-23T10:01:40Z |
| format | Article |
| id | doaj.art-14c8296d27c74f85b4a6889cf9604c04 |
| institution | Directory Open Access Journal |
| issn | 1721-727X |
| language | English |
| last_indexed | 2024-12-23T10:01:40Z |
| publishDate | 2017-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | European Journal of Inflammation |
| spelling | doaj.art-14c8296d27c74f85b4a6889cf9604c042022-12-21T17:51:12ZengSAGE PublishingEuropean Journal of Inflammation1721-727X2017-12-011510.1177/1721727X17733392Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in ChinaLi Huang0Yaping Xie1Huifeng Fan2Gen Lu3Jialu Yu4Chen Chen5Diyuan Yang6Pediatric Intensive Care Unit, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Infection, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Infection, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Infection, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Infection, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Infection, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaDepartment of Respiratory Infection, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, ChinaBronchiolitis obliterans (BO) is in general a rare and life-threatening form of non-reversible obstructive lung disease in which the bronchioles are compressed and narrowed by fibrosis and/or inflammation. The purpose of this study was to evaluate the clinical features of BO in pediatric patients and explore its risk factors. The medical records of 35 pediatric patients with BO at Guangzhou Women and Children’s Medical Center were evaluated. The age at onset of symptoms was 2–42 months (mean 13.3 ± 8.9 months), with age at diagnosis of 5 months–4 years (mean 17.8 ± 9.0 months). High-resolution computed tomography findings included mosaic pattern (100%), atelectasis (37.1%), air trapping (31.4%), and bronchiectasis (20.0%). Three patients received lung biopsies and mainly exhibited an inflammatory process surrounding the lumen of bronchioles. BO predominantly resulted from post-infectious causes (91.4%) which were primarily caused by adenovirus (50%), followed by Mycoplasma pneumoniae (46.7%) and influenza (20%). Pulmonary function tests (PFTs) showed severe and fixed airflow obstruction, decreased compliance, and increased resistance. No significant difference was found between before and after steroid treatment ( P > 0.05). Two patients died owing to severe pulmonary complications, one of whom had inherent immunodeficiency. Our study suggests that the occurrence of BO, especially post-infectious BO, in China is relatively high and might result from primary immunodeficiency diseases in severe cases. Recurrent aspiration pneumonia caused by congenital dysplasia of the larynx and vaccination not on schedule might be potential risk factors for persistent and recurrent BO.https://doi.org/10.1177/1721727X17733392 |
| spellingShingle | Li Huang Yaping Xie Huifeng Fan Gen Lu Jialu Yu Chen Chen Diyuan Yang Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China European Journal of Inflammation |
| title | Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China |
| title_full | Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China |
| title_fullStr | Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China |
| title_full_unstemmed | Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China |
| title_short | Clinical and follow-up study of bronchiolitis obliterans in pediatric patients in China |
| title_sort | clinical and follow up study of bronchiolitis obliterans in pediatric patients in china |
| url | https://doi.org/10.1177/1721727X17733392 |
| work_keys_str_mv | AT lihuang clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina AT yapingxie clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina AT huifengfan clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina AT genlu clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina AT jialuyu clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina AT chenchen clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina AT diyuanyang clinicalandfollowupstudyofbronchiolitisobliteransinpediatricpatientsinchina |