Plastic bronchitis: large, branching, mucoid bronchial casts in children

Bowen, AʼDelbert; Oudjhane, Kamaldine; Odagiri, Kazumasa; Liston, Stephen L.; Cumming, William A.; Oh, K S

doi:10.2214/ajr.144.2.371

Cited by 79 publications

(73 citation statements)

References 7 publications

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“…Histologic examination of the bronchial casts first showed highly structured fibrin with incorporated mucin. Other characteristics included hypercellularity with eosinophils, Charcot-Leyden crystals, and Curschmann's spirals [4,9,10].…”

Section: Discussionmentioning

confidence: 99%

“…Previously reported successful therapeutic interventions focused on optimizing post Fontan cardiac hemodynamics and lowering central venous pressure. Bowen et al demonstrated resolution of bronchial casts in a patient with pericardial effusion utilizing surgical pericardectomy [9]. Three additional cases of pericardial effusions and plastic bronchitis as a complication of Fontan operation have been detailed [2,13,33].…”

Section: Pathophysiologymentioning

confidence: 99%

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Successful Management of Plastic Bronchitis in a Child Post Fontan: Case Report and Literature Review

Randhawa

Chin

et al. 2012

Lung

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Section: Discussionmentioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

Successful Management of Plastic Bronchitis in a Child Post Fontan: Case Report and Literature Review

Randhawa

Chin

et al. 2012

Lung

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“…Bronchial casts are usually associated with diffuse bronchial hypersecretory disorders, such as mucoid impaction, asthma, allergic bronchopulmonary aspergillosis or mucoviscidosis [4][5][6], and are also reported to be present in pneumonia [4], pericardial effusion [5], and heart failure [7].…”

Section: Discussionmentioning

confidence: 99%

“…BOWEN et al [5] suggested that an elevated pulmonary venous pressure, present in the patient with pericardial effusion, may play a possible role in the pathogenesis of cast formation. In our patient, no specific therapy was given to lower pulmonary venous pressure, and we assumed that pulmonary venous pressure remained elevated throughout the study.…”

Section: Discussionmentioning

confidence: 99%

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Plastic bronchitis

Park¹,

Elshami²,

Kang³

et al. 1996

Eur Respir J

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Plastic bronchitis is generally associated with some type of pulmonary disease and improves either spontaneously or with medical therapy. We present a case of plastic bronchitis with no known cause.The patients' symptoms were not responsive to medical therapy but were relieved after right middle lobectomy. Eur Respir J., 1996, 9, 612- Plastic bronchitis, also known as fibrinous bronchitis or pseudomembranous bronchitis, denotes the presence of inspissated bronchial casts that may be coughed up or found at bronchoscopy or in surgical specimens [1][2][3]. Bronchial casts are generally associated with diffuse bronchial hypersecretory disorders, such as asthma or mucoviscidosis [4][5][6], and are also reported to be present in pneumonia [4], pericardial effusion [5], and heart failure [7]. Plastic bronchitis is usually self-limited or responsive to medical therapy, with a good prognosis [1][2][3][4][5].We report a case of plastic bronchitis not related to a specific bronchopulmonary disease. Our case was not responsive to medical therapy but improved after right middle lobe resection. Case reportA 17 year old man was admitted to the hospital with a one month history of cough and yellow sputum, which were not relieved by antibiotics and the usual expectorants. He had been relatively healthy despite being on digoxin and diuretics following heart surgery for Tetralogy of Fallot 5 yrs prior to admission. On examination, the patient appeared acutely and chronically ill. Blood pressure was 110/70 mmHg, pulse rate 80 beats·min -1 , respiratory rate 20 breaths·min -1 , and body temperature 37˚C. A grade III systolic murmur was heard at the cardiac apex and inspiratory crackles were present over both lower lung fields. There was no pitting oedema or clubbing. White blood cell count was 6,500 cells·mm -3 , with 52% neutrophils, 42% lymphocytes, 2% monocytes and 4% eosinophils. Sputum cultures grew alpha-haemolytic streptococci but no fungi or other pathogens.Chest roentgenogram showed bilateral patchy infiltrations with cardiomegaly. The heart size was unchanged compared with that recorded 2 months before admission ( fig. 1a). High resolution computed tomography (HRCT) scan showed bilateral patchy consolidations, both centrally and peripherally. No evidence of interstitial oedema was present ( fig. 1b). Echocardiography revealed left atrial and ventricular enlargement with mitral regurgitation. These findings were unchanged compared to the findings 6 months prior to admission. Spirometry was normal, with a forced vital capacity (FVC) of 4.01 L (102% of predicted), forced expiratory volume in one second (FEV1) of 3.52 L (102% pred), and FEV1/FVC of 87%. Transfer factor of the lungs for carbon monoxide was 20.4 mL·mm -1 ·mmHg -1 (74% pred). Breathing room air, arterial blood pH was 7.38, arterial carbon dioxide tension (Pa,CO 2 ) 4.8 kPa (36.2 mmHg) and arterial oxygen tension (Pa,O 2 ) 11.4 kPa (85.5 mmHg). Fibreoptic bronchoscopy disclosed widespread hyperaemic mucosa with viscid purulent secretion in the large bron...

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Plastic or Cast Bronchitis?

Bowen¹

1990

Arch Pediatr Adolesc Med

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Plastic bronchitis: large, branching, mucoid bronchial casts in children

Cited by 79 publications

References 7 publications

Successful Management of Plastic Bronchitis in a Child Post Fontan: Case Report and Literature Review

Successful Management of Plastic Bronchitis in a Child Post Fontan: Case Report and Literature Review

Plastic bronchitis

Plastic or Cast Bronchitis?

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