Analysis of Risk Factors of Bronchiolitis Obliterans in Children with Mycoplasma pneumoniae Bronchiolitis

Abstract

Objective. To investigate the related risk factors for bronchiolitis obliterans (BO) in children with mycoplasma pneumonia (MP) bronchiolitis. Method. The clinical data of 227 children with MP bronchiolitis who were admitted to the II Department of Respiratory of Children’s Hospital of Hebei Province from January 2018 to June 2020 were retrospectively analyzed. According to the sequelae of BO, they were divided into 32 cases in the BO group and 195 cases in the non-BO group. The univariate analysis was performed on the clinical and laboratory parameters of the two groups, and the multifactor logistic regression was performed further to determine the independent risk factors for the occurrence of BO in MP bronchiolitis, and then, the cut-off value with the maximum diagnostic value of indicators was found through the ROC curve analysis. Results. The results of univariate and multivariate logistic regression analysis showed that the independent risk factors for the occurrence of BO in MP bronchioles were longer duration of moist rales ( OR = 1.203 , P = 0.003 ), higher levels of serum lactate dehydrogenase (LDH) ( OR = 1.005 , P = 0.036 ), hypoxemia ( OR = 7.442 , P = 0.035 ), and pleural effusion ( OR = 4.437 , P = 0.004 ). The area under the ROC curve was 78.2%, 72.0%, 68.2%, and 71.0%, respectively ( P < 0.001 ). The cut-off value of duration of moist rales and levels of serum LDH are 7.5 d and 330 U/L, respectively. Conclusion. Children with MP bronchiolitis with high serum LDH level (≥330 U/L), combined with hypoxemia, pleural effusion, and lung wet rale duration (≥7.5 d), may be more prone to BO, in which lung wet rale duration prediction value is the largest. Among them, duration of pulmonary moist rales has the highest predictive value.

A Diagnostic Nomogram for Early Prediction of Post-Infectious Bronchiolitis Obliterans in Severe Pneumonia

“…However, the authors believed that MV was not an independent risk factor for BO. 8 Although our analysis found that MV was an important independent risk factor for predicting PIBO, whether MV could lead to lung injury and thus increase the risk of PIBO requires further and detailed studies in the future to clarify the relationship between MV and PIBO.…”

“…In addition, gastroesophageal reflux or connective tissue diseases can cause BO. [3][4][5][6][7][8] Post-infectious BO (PIBO) can be described as BO following an respiratory tract infection. 4 Most children with PIBO are characterized by recurrent respiratory tract infections, recurrent cough, asthma, poor exercise tolerance, and impaired lung function.…”

Bronchiolitis obliterans associated with toxic epidermal necrolysis induced by infection: A case report and literature review

“…BO may occur following acute MP bronchiolitis due to airway epithelial injury and sloughing (29). Hypoxemia and high level of lactate dehydrogenase are the risk factors for BO in children with MP Bronchiolitis (30,31). Our patient had hypoxemia and a high level of lactate dehydrogenase.…”

Importance of early follow‐up of Mycoplasma pneumoniae pneumonia in pediatric patients: A case series

“…3 Partial or total obstruction of the airway lumen results from the inflammatory development of granulation or fibrosis over time. According to Huang et al, 4 the most reliable indicator of PIBO risk is pulmonary rales lingering for ≥7.5 days. In Case 1, pulmonary moist rales did not decrease for more than 1 week after effective treatment.…”