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Clinical Characteristics and Long-Term Follow Up of Post-Infectious Bronchiolitis Obliterans in Children
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A6320 - Clinical Characteristics and Long-Term Follow Up of Post-Infectious Bronchiolitis Obliterans in Children
Author Block: H. Chung, Y. Jang; Dep. of Pediatrics Catholic Univ. of Daegu, Daegu, Korea, Republic of.
Rationale: Post-infectious bronchiolitis obliterans (PIBO) is an irreversible form of chronic obstructive lung disease secondary to severe lower respiratory infection (LRI). The children with PIBO usually show clinical improvement as lung develops, but impaired lung function might be persistent or sometimes progressive. We aimed to investigate the clinical characteristics and long-term follow up results of the children with PIBO. Methods: Forty-one patients who were diagnosed with PIBO under 3 years of age were enrolled. Diagnosis of PIBO was made according to the previously described criteria: 1) history of acute LRI in previously healthy children 2) unresolved respiratory symptoms associated with airway obstruction (cough, shortness of breath on exertion and/or abnormal breath sounds) that last for more than 6 weeks after the initial episode despite treatment 3) mosaic perfusion with air trapping, bronchiectasis, or atelectasis on pulmonary HRCT. Medical records were reviewed and examined for, age at initial insult, age at diagnosis, treatment modalities, atopic sensitization, duration of follow-up, and number of exacerbations. Spirometry and methacholine challenge test were performed at 6 years of age and lung function parameters were compared with those of age-matched control values using Z score. Results: Mean onset age was 21.8 months and diagnostic interval was 11.9 months. The mean follow-up period was 61.1 months. The patients with PIBO had recurrent exacerbations associated with LRI, and the mean number of exacerbations decreased significantly at 48 months of follow-up. PIBO patients showed significantly decreased Z score values of FEV1 and FEF25-75% compared with age-matched control values. Bronchial hyperresponsiveness was observed in more than 40% of PIBO patients, which was not related with the atopic status of the patients. Conclusion: The children with PIBO who had frequent exacerbations during the first years of the disease showed clinical improvement as they grow old. However, they had decreased lung function parameters and bronchial hyperresponsiveness. Our study suggests that PIBO during early infancy might cause chronic impairment of lung function.
Author Block: H. Chung, Y. Jang; Dep. of Pediatrics Catholic Univ. of Daegu, Daegu, Korea, Republic of.
Rationale: Post-infectious bronchiolitis obliterans (PIBO) is an irreversible form of chronic obstructive lung disease secondary to severe lower respiratory infection (LRI). The children with PIBO usually show clinical improvement as lung develops, but impaired lung function might be persistent or sometimes progressive. We aimed to investigate the clinical characteristics and long-term follow up results of the children with PIBO. Methods: Forty-one patients who were diagnosed with PIBO under 3 years of age were enrolled. Diagnosis of PIBO was made according to the previously described criteria: 1) history of acute LRI in previously healthy children 2) unresolved respiratory symptoms associated with airway obstruction (cough, shortness of breath on exertion and/or abnormal breath sounds) that last for more than 6 weeks after the initial episode despite treatment 3) mosaic perfusion with air trapping, bronchiectasis, or atelectasis on pulmonary HRCT. Medical records were reviewed and examined for, age at initial insult, age at diagnosis, treatment modalities, atopic sensitization, duration of follow-up, and number of exacerbations. Spirometry and methacholine challenge test were performed at 6 years of age and lung function parameters were compared with those of age-matched control values using Z score. Results: Mean onset age was 21.8 months and diagnostic interval was 11.9 months. The mean follow-up period was 61.1 months. The patients with PIBO had recurrent exacerbations associated with LRI, and the mean number of exacerbations decreased significantly at 48 months of follow-up. PIBO patients showed significantly decreased Z score values of FEV1 and FEF25-75% compared with age-matched control values. Bronchial hyperresponsiveness was observed in more than 40% of PIBO patients, which was not related with the atopic status of the patients. Conclusion: The children with PIBO who had frequent exacerbations during the first years of the disease showed clinical improvement as they grow old. However, they had decreased lung function parameters and bronchial hyperresponsiveness. Our study suggests that PIBO during early infancy might cause chronic impairment of lung function.
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