Post‐infectious bronchiolitis obliterans: Can CT scan findings at early age anticipate lung function?

Mattiello, Rita; Sarria, Edgar E.; Mallol, Javier; Fischer, Gilberto Bueno; Mocelin, Helena Teresinha; Bello, Rodrigo Moreira; Flores, José Antônio Monteiro; Irion, Klaus; Jones, Yvonne

doi:10.1002/ppul.21115

Cited by 34 publications

(33 citation statements)

References 29 publications

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“…Patients with bronchiolitis obliterans (BO) have been shown to have abnormal PFT, most often obstruction with FEV 1 as low as 19% [23][24][25]. Progressive abnormalities in the PFTs with an annual rate of decline of −1.01% for FEV 1 and −1.04% for FEV 25% to 75% have been reported [26].…”

Section: Examples Of Diseases With Obstructive Lung Diseasementioning

confidence: 97%

Pulmonary Function Testing in Young Children

Escobar

Carver

2011

Curr Allergy Asthma Rep

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Pulmonary function testing (PFT) is of great importance in the evaluation and treatment of respiratory diseases. Spirometry is simple, noninvasive, and has been the most commonly used technique in cooperative children, obtaining reliable data in only a few minutes. The development of commercially available equipment as well as the simplification of previous techniques that now require minimal patient cooperation applied during tidal breathing have significantly stimulated the use of PFT in younger children. Tidal breathing techniques such as impulse oscillometry, gas dilution, and plethysmography have permitted previously unobtainable PFT in children 2 to 5 years of age. The purpose of this review is to help clinicians become familiar with available PFT techniques used in young children by discussing their general principles, clinical applications, and limitations.

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Section: Examples Of Diseases With Obstructive Lung Diseasementioning

confidence: 97%

Pulmonary Function Testing in Young Children

Escobar

Carver

2011

Curr Allergy Asthma Rep

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“…Existem evidências de que as alterações tomográficas em menores de 3 anos podem predizer o comprometimento futuro da função pulmonar 54 .…”

Section: Provas De Função Pulmonarunclassified

“…Estudos em pacientes com BO pós-transplante pulmonar indicam que a azitromicina pode ter um efeito benéfico devido à sua ação anti-inflamatória relacionada à redução in vitro de IL-8, IL-6 e TNF-α, IL-1β 54 . Nesses pacientes, foi observada uma melhora da função pulmonar após 3 a 4 meses de uso desse macrolídeo em dias alternados 62,63 .…”

Section: Antibióticosunclassified

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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“…However, the sensitivity of CT for moderate or severe nontransplant BO in children is only modest, so that CT cannot exclude BO (Smith et al 2011). CT is valuable as a prognostic tool since severe abnormalities on CT in children under three years of age with post-infectious BO predict poor lung function several years later (Mattiello et al 2010).…”

Section: Bronchiolitis Obliteransmentioning

confidence: 99%