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Constant C, Pereira L, Saianda A, Ferreira R, Silva AM, Descalço A, Lobo L, Bandeira T. Should there be a tailored guided management plan for children with post-infectious bronchiolitis obliterans and bronchiectasis? Pulmonology 2023; 29:83-84. [PMID: 36117098 DOI: 10.1016/j.pulmoe.2022.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 07/16/2022] [Accepted: 07/18/2022] [Indexed: 01/28/2023] Open
Affiliation(s)
- C Constant
- Paediatric Respiratory Unit, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Paediatric Lung Function Laboratory, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Lisbon Academic Medical Centre, University of Lisbon, Lisbon, Portugal
| | - L Pereira
- Paediatric Respiratory Unit, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Lisbon Academic Medical Centre, University of Lisbon, Lisbon, Portugal
| | - A Saianda
- Paediatric Respiratory Unit, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - R Ferreira
- Paediatric Respiratory Unit, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Lisbon Academic Medical Centre, University of Lisbon, Lisbon, Portugal
| | - A M Silva
- Paediatric Lung Function Laboratory, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - A Descalço
- Paediatric Lung Function Laboratory, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - L Lobo
- General Radiology Service, Hospital de Santa Maria, CHULN, Lisbon, Portugal
| | - T Bandeira
- Paediatric Respiratory Unit, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Paediatric Lung Function Laboratory, Department of Paediatrics, Hospital de Santa Maria, CHULN, Lisbon, Portugal; Lisbon Academic Medical Centre, University of Lisbon, Lisbon, Portugal
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Liu D, Liu J, Zhang L, Chen Y, Zhang Q. Risk Factors for Post-infectious Bronchiolitis Obliterans in Children: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:881908. [PMID: 35757133 PMCID: PMC9218415 DOI: 10.3389/fped.2022.881908] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/03/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Post-infectious bronchiolitis obliterans (PIBO) is a long-term sequela after an initial insult to the lower respiratory tract. A comprehensive understanding of the factors that contribute to a high risk of developing PIBO is important to help define therapeutic strategies and improve prognosis. METHODS We performed a systematic review of published literature available in the online databases including PubMed, Embase, Web of Science, CNKI, Wan Fang, and VIP, with the last search updated on 27 January 2022. Observational studies and case-control studies that provide sufficient data to examine associations between potential risk factors and PIBO were included. Pooled odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) and heterogeneity were calculated. RESULTS A total of 14 risk factors were selected from 9 studies included in the analysis. The strongest risk factors were hypoxemia, mechanical ventilation, tachypnea, and wheezing. Hypoxemia conferred the greatest risk with pooled OR of 21.54 (95% CI: 10-46.36, p < 0.001). Mechanical ventilation ranked second (pooled OR 14.61, 95% CI: 7.53-28.35, p < 0.001). Use of γ-globulin, use of glucocorticoids, co-infection of bacteria, a history of wheezing, and being male were other prominent risk factors. The effects of premature birth, allergic rhinitis, and imaging finding (pulmonary consolidation, atelectasis, pleural effusion) are less clear and require further confirmation. Cases that developing PIBO had a lower age compared with controls (MD, -8.76 months, 95% CI: -16.50 to -1.02, p = 0.03). No significant differences were observed in the duration of fever (MD, 1.74 days, 95% CI: -0.07 to 3.54, p = 0.06). Children diagnosed with PIBO had higher LDH levels (MD, 264.69 U/L, 95% CI: 67.43 to 461.74, p = 0.008) and duration of hospitalization (MD, 4.50 days, 95% CI: 2.63 to 6.37, p < 0.001). CONCLUSION In this study, we found that the strongest risk factors for PIBO were hypoxemia, mechanical ventilation, tachypnea, and wheezing. Use of glucocorticoids, γ-globulin, co-infection of bacteria, a history of wheezing, and being male may also play a role. The factors discussed above can inform the generation of a clinical prediction model for the developing PIBO in children.
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Affiliation(s)
- Die Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Jing Liu
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Lipeng Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.,Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Yuanmei Chen
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
| | - Qi Zhang
- Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China
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Yazan H, Khalif F, Shadfaan LA, Bilgin S, Nursoy M, Cakir FB, Cakin ZE, Uzuner S, Cakir E. Post-infectious bronchiolitis obliterans in children: Clinical and radiological evaluation and long-term results. Heart Lung 2021; 50:660-666. [PMID: 34098236 DOI: 10.1016/j.hrtlng.2021.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 04/26/2021] [Accepted: 05/05/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND 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 clinical and radiological findings were compared. RESULTS The median age of the patients at initial pulmonary injury was 7,2 months, the median age at diagnosis was 17.5 months. Persistent wheezing was the most common complaint. Thirty-five patients had mechanical ventilation history. 82,5% of patients had clinical improvement. Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT improved significantly with treatment. Post-treatment Bhalla scores decreased from 8.3 to 6.5 (p= 0,001). Improvement was observed in radiological and clinical findings after treatment. CONCLUSIONS This study is one of the largest studies in the literature and one of the few studies that evaluate clinical and radiological outcomes of patients with PIBO.
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Affiliation(s)
- Hakan Yazan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey.
| | - Fathouma Khalif
- Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Lina Al Shadfaan
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Sennur Bilgin
- Department of Radiology, Faculty of Medicine, Münster University
| | - Mustafa Nursoy
- Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Fatma Betül Cakir
- Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Zeynep Ebru Cakin
- Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Selcuk Uzuner
- Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
| | - Erkan Cakir
- Division of Pediatric Pulmonology, Faculty of Medicine, Bezmialem Vakif University, İstanbul, Turkey
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Postinfectious Bronchiolitis Obliterans in Children: Diagnostic Workup and Therapeutic Options: A Workshop Report. Can Respir J 2020; 2020:5852827. [PMID: 32076469 PMCID: PMC7013295 DOI: 10.1155/2020/5852827] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 11/29/2019] [Accepted: 12/27/2019] [Indexed: 12/23/2022] Open
Abstract
Bronchiolitis obliterans (BO) is a rare, chronic form of obstructive lung disease, often initiated with injury of the bronchiolar epithelium followed by an inflammatory response and progressive fibrosis of small airways resulting in nonuniform luminal obliteration or narrowing. The term BO comprises a group of diseases with different underlying etiologies, courses, and characteristics. Among the better recognized inciting stimuli leading to BO are airway pathogens such as adenovirus and mycoplasma, which, in a small percentage of infected children, will result in progressive fixed airflow obstruction, an entity referred to as postinfectious bronchiolitis obliterans (PIBO). The present knowledge on BO in general is reasonably well developed, in part because of the relatively high incidence in patients who have undergone lung transplantation or bone marrow transplant recipients who have had graft-versus-host disease in the posttransplant period. The cellular and molecular pathways involved in PIBO, while assumed to be similar, have not been adequately elucidated. Since 2016, an international consortium of experts with an interest in PIBO assembles on a regular basis in Geisenheim, Germany, to discuss key areas in PIBO which include diagnostic workup, treatment strategies, and research fields.
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Maia SA, Eli D, Cunha R, Bitencourt E, Riedi CA, Chong Neto HJ, Silva DCCE, Rosário Filho NA. Clinical, functional, and cytological evaluation of sputum in postinfectious bronchiolitis obliterans: a possible overlap with asthma? ACTA ACUST UNITED AC 2019; 45:e20190060. [PMID: 31618291 PMCID: PMC7247770 DOI: 10.1590/1806-3713/e20190060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - Denise Eli
- . Complexo do Hospital de Clínicas, Universidade Federal do Paraná, Curitiba (PR) Brasil
| | - Roberta Cunha
- . Complexo do Hospital de Clínicas, Universidade Federal do Paraná, Curitiba (PR) Brasil
| | - Elessandra Bitencourt
- . Complexo do Hospital de Clínicas, Universidade Federal do Paraná, Curitiba (PR) Brasil
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In Suh D, Song DJ, Baek HS, Shin M, Yoo Y, Kwon JW, Jang GC, Yang HJ, Lee E, Kim HS, Seo JH, Woo SI, Kim HY, Shin YH, Lee JS, Yoon J, Jung S, Han M, Eom E, Yu J, Kim WK, Lim DH, Kim JT, Chang WS, Lee JK. Korean childhood asthma study (KAS): a prospective, observational cohort of Korean asthmatic children. BMC Pulm Med 2019; 19:64. [PMID: 30876418 PMCID: PMC6420748 DOI: 10.1186/s12890-019-0829-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 03/06/2019] [Indexed: 12/14/2022] Open
Abstract
Background Asthma is a syndrome composed of heterogeneous disease entities. Although it is agreed that proper asthma endo-typing and appropriate type-specific interventions are crucial in the management of asthma, little data are available regarding pediatric asthma. Methods We designed a cluster-based, prospective, observational cohort study of asthmatic children in Korea (Korean childhood Asthma Study [KAS]). A total of 1000 Korean asthmatic children, aged from 5 to 15 years, will be enrolled at the allergy clinics of the 19 regional tertiary hospitals from August 2016 to December 2018. Physicians will verify the relevant histories of asthma and comorbid diseases, as well as airway lability from the results of spirometry and bronchial provocation tests. Questionnaires regarding subjects’ baseline characteristics and their environment, self-rating of asthma control, and laboratory tests for allergy and airway inflammation will be collected at the time of enrollment. Follow-up data regarding asthma control, lung function, and environmental questionnaires will be collected at least every 6 months to assess outcome and exacerbation-related aggravating factors. In a subgroup of subjects, peak expiratory flow rate will be monitored by communication through a mobile application during the overall study period. Cluster analysis of the initial data will be used to classify Korean pediatric asthma patients into several clusters; the exacerbation and progression of asthma will be assessed and compared among these clusters. In a subgroup of patients, big data-based deep learning analysis will be applied to predict asthma exacerbation. Discussion Based on the assumption that asthma is heterogeneous and each subject exhibits a different subset of risk factors for asthma exacerbation, as well as a different disease progression, the KAS aims to identify several asthma clusters and their essential determinants, which are more suitable for Korean asthmatic children. Thereafter we may suggest cluster-specific strategies by focusing on subjects’ personalized aggravating factors during each exacerbation episode and by focusing on disease progression. The KAS will provide a good academic background with respect to each interventional strategy to achieve better asthma control and prognosis.
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Affiliation(s)
- Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Dae Jin Song
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Hey-Sung Baek
- Department of Pediatrics, Hallym University Kangdong Sacred Heart Hospital, Seoul, South Korea
| | - Meeyong Shin
- Department of Pediatrics, Soonchunhyang University School of Medicine, Bucheon, South Korea
| | - Young Yoo
- Department of Pediatrics, Korea University Anam Hospital, Seoul, South Korea
| | - Ji-Won Kwon
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Gwang Cheon Jang
- Department of Pediatrics, National Health Insurance Service Ilsan Hospital, Ilsan, South Korea
| | - Hyeon-Jong Yang
- Department of Pediatrics, Pediatric Allergy and Respiratory Center, Soonchunhyang University College of Medicine, Seoul, South Korea
| | - Eun Lee
- Department of Pediatrics, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea
| | - Hwan Soo Kim
- Department of Pediatrics, School of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, South Korea
| | - Ju-Hee Seo
- Department of Pediatrics, Dankook University Hospital, Cheonan, South Korea
| | - Sung-Il Woo
- Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, South Korea
| | - Hyung Young Kim
- Department of Pediatrics, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Youn Ho Shin
- Department of Pediatrics, Gangnam CHA Medical Center CHA University School of Medicine, Seoul, South Korea
| | - Ju Suk Lee
- Department of Pediatrics, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea
| | - Jisun Yoon
- Department of Pediatrics, Mediplex Sejong hospital, Incheon, South Korea
| | - Sungsu Jung
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Minkyu Han
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, Seoul, South Korea
| | - Eunjin Eom
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul, South Korea
| | - Jinho Yu
- Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Woo Kyung Kim
- Department of Pediatrics, Inje University Seoul Paik Hospital, Seoul, South Korea.
| | - Dae Hyun Lim
- Department of Pediatrics, School of Medicine, Inha University, Incheon, South Korea
| | - Jin Tack Kim
- Department of Pediatrics, School of Medicine, The Catholic University of Korea, Uijeongbu St. Mary's hospital, Uijeongbu, South Korea
| | - Woo-Sung Chang
- Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, South Korea
| | - Jeom-Kyu Lee
- Division of Allergy and Chronic Respiratory Diseases, Center for Biomedical Sciences, Korea National Institute of Health, Korea Centers for Disease Control and Prevention, Osong, South Korea
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Zhao C, Liu J, Yang H, Xiang L, Zhao S. Mycoplasma pneumoniae-Associated Bronchiolitis Obliterans Following Acute Bronchiolitis. Sci Rep 2017; 7:8478. [PMID: 28814783 PMCID: PMC5559585 DOI: 10.1038/s41598-017-08861-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 07/14/2017] [Indexed: 11/24/2022] Open
Abstract
The characteristics of Mycoplasma pneumonia (M. pneumoniae)-associated bronchiolitis obliterans (BO) are not well known. We retrospectively reviewed 17 patients with M. pneumoniae–associated BO. All patients had M. pneumoniae–associated acute bronchiolitis prior to the development of BO. In the acute bronchiolitis stage, all patients had fever and cough; six patients also had wheezing and dyspnoea. BO was diagnosed approximately 1.5–8 months later based on clinical manifestations and chest high-resolution computed tomography (HRCT) findings. All patients presented with wheezing and/or dyspnoea at the time of diagnosis of BO. HRCT findings included mosaic attenuation, pronounced air trapping, central bronchiectasis and emphysema, according to disease severity. Lung function tests revealed mild to severe airway obstruction. Fourteen of 17 patients had a greater than 12% increase in forced expiratory volume in 1 second values after taking salbutamol. All patients had positive allergy test results and family or personal history of atopic disease. Four patients had a history of asthma before M. pneumonia bronchiolitis. Asthma was diagnosed before, at the time of or after the diagnosis of BO in 11 cases. M. pneumoniae–associated BO may therefore develop following M. pneumonia bronchiolitis and overlap with asthma.
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Affiliation(s)
- Chengsong Zhao
- Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, People's Republic of China
| | - Jinrong Liu
- Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, People's Republic of China
| | - Haiming Yang
- Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, People's Republic of China
| | - Li Xiang
- Department of Allergy, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, People's Republic of China
| | - Shunying Zhao
- Department of Respiratory Medicine, Beijing Children's Hospital, National Center for Children's Health, Capital Medical University, Beijing, 100045, People's Republic of China.
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Gur M, Yaacoby-Bianu K, Ilivitzki A, Bar-Yoseph R, Nir V, Hakim F, Toukan Y, Bentur L. Lung Clearance Index (LCI) in Patients with Bronchiolitis Obliterans: A Preliminary Report and Comparison to Cystic Fibrosis Patients. Lung 2016; 194:1007-1013. [PMID: 27645685 DOI: 10.1007/s00408-016-9934-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 08/17/2016] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Bronchiolitis obliterans (BO) is a chronic airway disease following an insult to the lower respiratory tract. Lung clearance index (LCI) measures ventilation inhomogeneity and has been studied in cystic fibrosis (CF). We aimed to evaluate LCI in BO and to compare it to LCI in CF patients. METHODS LCI was measured in BO patients, compared to CF patients, and correlated with spirometry and CT findings. RESULTS Twenty BO patients and 26 CF patients (with similar mean age and BMI) underwent evaluation. FEV1 % and FEF25-75 % predicted were significantly lower in the BO group (60.5 ± 17.8 vs. 72.7 ± 20.7, p = 0.041, and 42.8 ± 22.8 vs. 66.4 ± 37.4, p = 0.017, respectively). In both groups, LCI was inversely correlated with FVC %, FEV1 %, and FEF25-75 % predicted. LCI % was slightly higher (190.4 ± 63.5 vs. 164.9 ± 39.4, p = 0.1) and FRC gas % (measured by multiple breath washout) was significantly higher in the BO group (92.5 ± 35.9 vs. 71.3 ± 18, p = 0.014). The strength of statistical association between the lower FEF25-75 % values and the higher LCI values was stronger in BO patients. CONCLUSIONS Similar to CF, LCI may provide estimation of ventilation inhomogeneity in BO. The results indicate greater small airway involvement and air trapping in BO. Further prospective longitudinal studies evaluating the correlation of LCI measurements with multiple clinical and physiological parameters should be performed to assess the clinical benefit of LCI measurement in BO.
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Affiliation(s)
- Michal Gur
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel
| | - Karin Yaacoby-Bianu
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel
| | - Anat Ilivitzki
- Pediatric Radiology Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Ronen Bar-Yoseph
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel
| | - Vered Nir
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel
| | - Fahed Hakim
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Yazeed Toukan
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Lea Bentur
- Pediatric Pulmonary Institute and CF Center, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, PO Box 9602, 31092, Haifa, Israel. .,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
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Castro-Rodriguez JA, Giubergia V, Fischer GB, Castaños C, Sarria EE, Gonzalez R, Mattiello R, Vega-Briceño LE, Murtagh P. Postinfectious bronchiolitis obliterans in children: the South American contribution. Acta Paediatr 2014; 103:913-21. [PMID: 24832610 DOI: 10.1111/apa.12689] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 04/18/2014] [Accepted: 05/12/2014] [Indexed: 11/30/2022]
Abstract
UNLABELLED Postinfectious bronchiolitis obliterans (PIBO) is an infrequent chronic lung that causes irreversible obstruction and, or, obliteration of the smaller airways. This review particularly focuses on more than 30 studies from South America. CONCLUSION The initial PIBO event occurs in the early years of life and is strongly associated with adenovirus infection and the need for mechanical ventilator support. Treatment requires a multidisciplinary strategy. Multicentre studies are needed to determine progression, optimal management and long-term follow-up.
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Affiliation(s)
- Jose A. Castro-Rodriguez
- Pulmonology Unit; Departments of Pediatrics; School of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Veronica Giubergia
- Pulmonology Department; Hospital de Pediatria Dr Juan P. Garrahan; Buenos Aires Argentina
| | - Gilberto B. Fischer
- Department of Pediatrics; Universidade Federal de Ciencias da Saude; Porto Alegre Brazil
| | - Claudio Castaños
- Pulmonology Department; Hospital de Pediatria Dr Juan P. Garrahan; Buenos Aires Argentina
| | - Edgar E. Sarria
- Centro Infant- Instituto de Pesquisas Biomédicas; Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre Brasil
| | - Ramiro Gonzalez
- Department of Pediatrics; Clinica Las Condes; Santiago Chile
| | - Rita Mattiello
- Centro Infant- Instituto de Pesquisas Biomédicas; Pontifícia Universidade Católica do Rio Grande do Sul; Porto Alegre Brasil
| | - Luis E. Vega-Briceño
- Department of Pediatrics; Clinica Alemana; Universidad del Desarrollo; Santiago Chile
| | - Patricia Murtagh
- Pulmonology Department; Hospital de Pediatria Dr Juan P. Garrahan; Buenos Aires Argentina
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Diffuse Lung Disease. PEDIATRIC CHEST IMAGING 2014. [PMCID: PMC7120093 DOI: 10.1007/174_2014_1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Diffuse lung disease (DLD) comprises a diverse group of disorders characterized by widespread pulmonary parenchymal pathology and impaired gas exchange. While many of these disorders are categorized under the rubric of interstitial lung disease (ILD), some of these disorders involve the airspaces or peripheral airways in addition to, or rather than, the interstitium. Some of these disorders are present primarily in infancy or early childhood, while others that are prevalent in adulthood rarely occur in childhood. This chapter will review the classification of pediatric DLD and the characteristic imaging findings of specific disorders to facilitate accurate diagnosis and guide appropriate treatment of children with these disorders.
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