Post- infectious bronchiolitis obliterans in children: clinical and radiological evaluation and lon- term results

Abstract

Objective: This study aims to evaluate clinical and radiological findings and treatment outcomes of the patients with PIBO. Methods: One hundred fourteen children were enrolled. Initial demographic and clinical findings were evaluated.Pre-and post-treatment symptoms, radiological findings and scores, the number of admissions to the hospital and PICU were compared. Results: Seventy-three patients were male. The median age of the patients at initial pulmonary injury was 7.2 months, the median age at diagnosis was 17.5 months and the median interval from initial injury to diagnosis was 8.5 months. Thirty-five patients had mechanical ventilation history. Persistent wheezing was the most common complaints. The most common radiological findings were peribronchial thickening and air-trapping. Sixty-eight patients were treated with inhaled corticosteroid (IC), systemic corticosteroid (SC) and azithromycin (AZT) combination. 25 patients were treated with only IC, 14 with IC and AZT, and 7 with IC and SC. 82,5% of patients had clinical improvement. Chronic respiratory failure occurred in 11 patients, and three patients died. Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT improved significantly. Bhalla scores decreased from 8.3 to 6.5 (p= 0,001). IC, SC and AZT combination was effective than the other treatments. Conclusions: This study is one of the largest studies in the literature and one of the few studies that evaluate clinical and radiological outcomes. We found that IC, AZT and SC combination is clinically and radiologically effective in patients with PIBO.