Bronchiolitis obliterans in children

Moonnumakal, Siby P.; Fan, Leland L.

doi:10.1097/mop.0b013e3282ff62e9

Cited by 128 publications

(153 citation statements)

References 24 publications

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“…A BO é o processo final comum a várias injúrias pulmonares, no entanto, em mais de 1/3 dos casos, a causa é desconhecida 8 .…”

Section: Etiologiaunclassified

“…A infecção por VRS como possível causa de BOPI tem sido questionada, uma vez que, apesar de ser o agente mais associado à bronquiolite viral aguda (BVA), existem poucos relatos na literatura de BOPI secundária por VRS 5,8 . Contudo, esse vírus tem sido identificado em pacientes que evoluem com BOPI em até 30% dos casos 10 .…”

Section: Etiologiaunclassified

“…Outros autores sugerem que descendentes asiáticos seriam mais suscetíveis à doença, uma vez que existem relatos em descendentes da Polinésia na Nova Zelândia, além de relatos na Coreia do Sul e Taiwan 8 .…”

Section: Epidemiologiaunclassified

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Post-infectious bronchiolitis obliterans in children

Champs

Lasmar²,

Camargos³

et al. 2011

J Pediatr (Rio J)

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Objective: To review publications about the main features of postinfectious bronchiolitis obliterans and its history, etiology, epidemiology, risk factors, pathogenesis, histological findings, clinical presentation, complementary tests, diagnostic criteria, differential diagnosis, treatment and prognosis.Sources: Non-systematic review of MEDLINE and LILACS databases and selection of 66 most relevant studies. Summary of the findings:In the post-infectious bronchiolitis obliterans there is an insult to respiratory epithelial cells, and its clinical severity is associated with the degree of lesion and inflammation. Diagnosis is made according to clinical signs and symptoms, by exclusion of main differential diagnoses and with the aid of complementary tests. High resolution CT, particularly images obtained during inspiration and expiration, provide information for the evaluation of the small airways. Pulmonary function tests show fixed airway obstructions and marked decrease of FEF 25-75% . Treatment has not been definitely established, and corticoids have been administered as pulse therapy or by inhalation of high doses of steroids. However, data about its efficacy are scarce in the literature. Long-term prognosis is variable, and there might be either clinical improvement or deterioration into respiratory insufficiency and death.Conclusion: Post-infectious bronchiolitis obliterans is a disease with a high morbidity rate; it should be treated by a multidisciplinary team, and patients should be followed up for a long period of time.J Pediatr (Rio J). 2011;87(3):187-198: Bronchiolitis obliterans, diagnosis, spirometry, CT, child. ResumoObjetivo: Revisar os trabalhos publicados sobre os principais aspectos da bronquiolite obliterante pós-infecciosa, relacionados com sua história, etiologia, epidemiologia, fatores de risco, patogenia, alterações histológicas, manifestações clínicas, exames complementares, critérios diagnósticos, diagnóstico diferencial, tratamento e prognóstico. Fonte dos dados:Realizou-se uma revisão não sistemática nas bases de dados MEDLINE e LILACS, selecionando-se 66 referências mais relevantes. Síntese dos dados:Na bronquiolite obliterante pós-infecciosa ocorre lesão do epitélio respiratório, e a gravidade clínica está relacionada aos diferentes graus de lesão e ao processo inflamatório. O diagnóstico baseia-se no quadro clínico, na exclusão dos principais diagnósticos diferenciais e no auxílio dos exames complementares. A tomografia computadorizada de alta resolução, principalmente com imagens em inspiração e expiração, possibilta a avaliação das pequenas vias aéreas. As provas de função pulmonar caracterizam-se por padrão obstrutivo fixo com redução acentuada do FEF 25-75% . O tratamento não está bem estabelecido, e o uso de corticoides tem sido preconizado em forma de pulsoterapia ou por via inalatória em elevadas doses, no entanto, os dados da literatura a respeito de sua eficácia ainda são escassos. O prognóstico a longo prazo é variável, podendo haver melhora clínica ou evolução par...

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“…A BO é o processo final comum a várias injúrias pulmonares, no entanto, em mais de 1/3 dos casos, a causa é desconhecida 8 .…”

Section: Etiologiaunclassified

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Post-infectious bronchiolitis obliterans in children

Champs

Lasmar²,

Camargos³

et al. 2011

J Pediatr (Rio J)

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“…Some of the possible BO etiologies are: inhalation of irritant substance, aspiration syndromes, immunological abnormalities, collagen diseases (rheumatoid arthritis and Sjögren syndrome), organ transplantation, Stevens-Johnson syndrome and postinfection. Among children, postinfectious BO is the most frequent (6,7) and occurs mainly in the southern hemisphere (Argentina, Chile, New Zealand and Australia), which suggests that it might be associated with genetic factors. The expression of the HLA-DR8-DQB1*0302 antigen is high among children with BO in Argentina (3,7,8) .…”

Section: Introductionmentioning

confidence: 99%

“…Among children, postinfectious BO is the most frequent (6,7) and occurs mainly in the southern hemisphere (Argentina, Chile, New Zealand and Australia), which suggests that it might be associated with genetic factors. The expression of the HLA-DR8-DQB1*0302 antigen is high among children with BO in Argentina (3,7,8) .…”

Section: Introductionmentioning

confidence: 99%

Bronquiolite obliterante: perfil clínico e radiológico de crianças acompanhadas em ambulatório de referência

Lino

Batista

Soares

et al. 2013

Rev. paul. pediatr.

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Objectives: To describe the clinical and radiological characteristics of patients with bronchiolitis obliterans.Methods: This is a retrospective and descriptive study. Data were collected from patients diagnosed with bronchiolitis obliterans between 2004 and 2008 in the Pediatric Pulmonology Clinic of Hospital Infantil Albert Sabin, in Ceará, Northeast Brazil. Such diagnosis was based on clinical and tomographic criteria. Previous history, clinical findings at the diagnosis, complementary exams, and follow-up data were evaluated.Results: 35 children diagnosed with bronchiolitis obliterans were identified. There was a predominance of male patients (3:1). The mean age at the onset of symptoms was 7.5 months, and bronchiolitis obliterans was diagnosed at a mean age of 21.8 months. The most common clinical findings were crackles/wheezing, tachypnea, dyspnea, and chest deformity. Post-infectious etiology was the main cause of bronchiolitis obliterans. Predominant findings at chest X-ray and high resolution computed tomography were peribronchial thickening and mosaic pattern, respectively. The treatment was variable and individualized. The majority of patients improved during follow-up, despite the persistence of respiratory symptoms.Conclusions: In this study, the predominance of male patients and post-infectious etiology was noted, corroborating scientific literature. The most common tomographic findings were similar to those described in previous studies (mosaic pattern, peri-bronchial thickening, and bronchiectasis). Evidence about the treatment of this disease is still lacking. The diagnosis was delayed, which indicates that clinical suspicion of bronchiolitis obliterans is necessary in children with persistent and severe wheezing. Conclusões: A presente casuística de bronquiolite obliterante mostrou predominância de pacientes do sexo masculino e de etiologia pós-infecciosa, corroborando os dados da literatura. Os achados tomográficos mais encontrados foram semelhantes aos descritos em trabalhos anteriores (perfusão em mosaico, espessamento peribrôn-quico e bronquiectasias). Ainda faltam evidências acerca do tratamento para esta doença. O diagnóstico de bronquiolite obliterante foi tardio, necessitando da suspeição clínica por parte dos pediatras frente a lactentes chiadores graves e perenes. KeyPalavras-chave: bronquiolite obliterante; criança; tomografia computadorizada espiral; pneumopatias obstrutivas. RESUMENObjetivo: Describir las características clínico-radiológicas de los pacientes con bronquiolitis obliterante acompañados en el Ambulatorio de Pneumología Pediátrica del Hospital Infantil Albert Sabin en la provincia de Ceará (Brasil).Métodos: Estudio descriptivo y retrospectivo. Se recogieron datos de pacientes diagnosticados con bronquiolitis obliterante entre 2004 y 2008. El diagnóstico se basó en criterios clínicos y tomográficos. Se evaluaron la historia previa, el cuadro clínico en el momento del diagnóstico, exámenes complementares y evolución.Resultados: Se identificaron 35 pacientes diagno...

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Pediatric transplantation

Harmon

2011

Primer on Transplantation

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Bronchiolitis obliterans in children

Cited by 128 publications

References 24 publications

Post-infectious bronchiolitis obliterans in children

Post-infectious bronchiolitis obliterans in children

Bronquiolite obliterante: perfil clínico e radiológico de crianças acompanhadas em ambulatório de referência

Pediatric transplantation

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