Associação de bronquiolite obliterante pós-infecciosa e hemossiderose pulmonar na infância

Abstract

In the present report, we describe an unusual presentation of post-infectious bronchiolitis obliterans accompanied by pulmonary hemosiderosis in a nine-year-old boy with persistent respiratory symptoms subsequent to an episode of acute bronchiolitis occurring at the age of seven months. After the episode, the persistent respiratory symptoms worsened significantly, and, by the age of seven, the patient began to have difficulty breathing after minimal exertion. Computed tomography of the chest presented findings consistent with bronchiolitis obliterans. Open lung biopsy revealed numerous hemosiderin-laden macrophages, as well as other findings consistent with bronchiolitis obliterans. Pulmonary hemosiderosis can occasionally be accompanied by bronchiolitis obliterans in children with severe sequelae after an episode of viral infection.

Bronchoalveolar lavage hemosiderosis in lightly active or sedentary horses

“…32,33 Case studies in humans have found that conditions such as idiopathic pulmonary fibrosis and bronchiolitis obliterans, in which the lower airways develop severe inflammation secondary to previous injury, can result in pulmonary hemosiderosis. 34,35 Moreover, increased percentages of hemosiderophages have been associated with higher risk of infection. 36 In our study, sEA was found to be a risk factor for alveolar hemosiderosis.…”

“…Individuals with COPD have increased concentrations of the inflammatory cytokine interleukin‐6 that initiates the process of iron sequestration in pulmonary macrophages and consequently weakens macrophage immune function 32,33 . Case studies in humans have found that conditions such as idiopathic pulmonary fibrosis and bronchiolitis obliterans, in which the lower airways develop severe inflammation secondary to previous injury, can result in pulmonary hemosiderosis 34,35 . Moreover, increased percentages of hemosiderophages have been associated with higher risk of infection 36 …”

Pulmonary Hemosiderosis in Children with Bronchopulmonary Dysplasia

“…Therefore, prior history of BPD and its associated lung damage may predispose to increased risk of recurrent pulmonary hemorrhage and lower respiratory tract infections. Similarly, a 9-year-old male developed postinfectious bronchiolitis obliterans with PH, confirmed by lung biopsy and CT scan, following a viral infection at 7 months of age with years of persistent respiratory symptoms [ 9 ]. Further studies are needed to delineate a link between prematurity-related BPD and IPH.…”

“…Calculating the percent of HLM may improve the sensitivity to 100% and the specificity to 96% when an index of 35% or more is used [ 17 ]. Biopsy may be helpful in some cases of protracted pulmonary disease as in the case with bronchiolitis obliterans described by Pinto et al [ 9 ]. The logistics and risk of lung biopsy in a child with an active pulmonary hemorrhage should be considered carefully.…”