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田 小, 张 光, 王 崇, 谷 瑞, 李 媛, 李 沁, 罗 健, 罗 征. [Clinical characteristics of plastic bronchitis and risk factors for recurrence in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2023; 25:626-632. [PMID: 37382133 PMCID: PMC10321426 DOI: 10.7499/j.issn.1008-8830.2211122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/23/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVES To study the clinical characteristics of plastic bronchitis (PB) in children and investigate the the risk factors for recurrence of PB. METHODS This was a retrospective analysis of medical data of children with PB who were hospitalized in Children's Hospital of Chongqing Medical University from January 2012 to July 2022. The children were divided into a single occurrence of PB group and a recurrent PB group and the risk factors for recurrence of PB were analyzed. RESULTS A total of 107 children with PB were included, including 61 males (57.0%) and 46 females (43.0%), with a median age of 5.0 years, and 78 cases (72.9%) were over 3 years old. All the children had cough, 96 children (89.7%) had fever, with high fever in 90 children. Seventy-three children (68.2%) had shortness of breath, and 64 children (59.8%) had respiratory failure. Sixty-six children (61.7%) had atelectasis and 52 children (48.6%) had pleural effusion. Forty-seven children (43.9%) had Mycoplasma pneumoniae infection, 28 children (26.2%) had adenovirus infection, and 17 children (15.9%) had influenza virus infection. Seventy-one children (66.4%) had a single occurrence of PB, and 36 cases (33.6%) had recurrent occurrence of PB (≥2 times). Multivariate logistic regression analysis showed that involvement of ≥2 lung lobes (OR=3.376) under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts (OR=3.275), and concomitant multi-organ dysfunction outside the lungs (OR=2.906) were independent risk factors for recurrent occurrence of PB (P<0.05). CONCLUSIONS Children with pneumonia accompanied by persistent high fever, shortness of breath, respiratory failure, atelectasis or pleural effusion should be highly suspected with PB. Involvement of ≥2 lung lobes under bronchoscopy, continued need for invasive ventilation after initial removal of plastic casts, and concomitant multi-organ dysfunction outside the lungs may be risk factors for recurrent occurrence of PB.
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Li Y, Li L, Zhao H, Gao X, Li S. The Identification and Clinical Value Evaluation of CYCS Related to Asthma through Bioinformatics Analysis and Functional Experiments. DISEASE MARKERS 2023; 2023:5746940. [PMID: 37091894 PMCID: PMC10121352 DOI: 10.1155/2023/5746940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/30/2022] [Indexed: 04/25/2023]
Abstract
Background Asthma is one of the most common respiratory diseases and one of the largest burdens of health care resources across the world. This study is aimed at using bioinformatics methods to find effective clinical indicators for asthma and conducting experimental validation. Methods We downloaded GSE64913 data and performed differentially expressed gene (DEG) screening. Weighted gene coexpression network analysis (WGCNA) on DEGs was applied to identify key module most associated with asthma for protein-protein interaction (PPI) analysis. According to the degree value, ten genes were obtained and subjected to expression analysis and receiver operating characteristic (ROC) analysis. Next, key genes were screened for expression analysis and immunological analysis. Finally, cell counting kit-8 (CCK-8) and qRT-PCR were also conducted to observe the influence of hub gene on cell proliferation and inflammatory cytokines. Results From the GSE64913 dataset, 711 upregulated and 684 downregulated DEGs were found. In WGCNA, the top 10 genes in the key module were examined by expression analysis in asthma, and CYCS was determined as an asthma-related oncogene with a good predictive ability for the prognosis of asthmatic patients. CYCS is significantly associated with immune cells, such as HHLA2, IDO1, TGFBR1, and CCL18 and promoted the proliferation of asthmatic cells in vitro. Conclusion CYCS plays an oncogenic role in the pathophysiology of asthma, indicating that this gene may become a novel diagnostic biomarker and promising target of asthma treatment.
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Affiliation(s)
- Yan Li
- Department of Pulmonary Medicine, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, China 201199
| | - Li Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China 200032
| | - Hua Zhao
- Department of Pulmonary Medicine, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, China 201199
| | - Xiwen Gao
- Department of Pulmonary Medicine, Minhang Hospital, Fudan University, 170 Xinsong Road, Shanghai, China 201199
| | - Shanqun Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, China 200032
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Zhang H, Yang J, Zhao W, Zhou J, He S, Shang Y, Cheng Q. Clinical features and risk factors of plastic bronchitis caused by refractory Mycoplasma pneumoniae pneumonia in children: a practical nomogram prediction model. Eur J Pediatr 2023; 182:1239-1249. [PMID: 36633659 PMCID: PMC10023623 DOI: 10.1007/s00431-022-04761-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 12/07/2022] [Accepted: 12/09/2022] [Indexed: 01/13/2023]
Abstract
Early assessment of refractory Mycoplasma pneumoniae pneumonia (RMPP) with plastic bronchitis (PB) allows timely removal of casts using fiberoptic bronchoscopic manipulation, which relieves airway obstruction and limit sequelae development. This study aimed to analyze clinical data for risk factors and develop a nomogram for early predictive evaluation of RMPP with PB. The clinical data of 1-14 year-old patients with RMPP were retrospectively analyzed. Patients were classified into a PB or non-PB group. The general characteristics, clinical symptoms, laboratory test results, imaging findings, and microscopic changes of the two groups were compared. A statistical analysis of the risk factors for developing PB was performed, and a nomogram model of risk factors was constructed. Of 120 patients with RMPP included, 68 and 52 were in the non-PB and PB groups, respectively. Using multivariate logistic regression analysis, fever before bronchoscopy, extrapulmonary complications, pleural effusion, cough duration, and lactate dehydrogenase (LDH) levels were identified as risk factors. A nomogram was constructed based on the results of the multivariate analysis. The area under the receiver operating characteristic curve value of the nomogram was 0.944 (95% confidence interval: 0.779-0.962). The Hosmer-Lemeshow test displayed good calibration of the nomogram (p = 0.376, R2 = 0.723). CONCLUSION The nomogram model constructed in this study based on five risk factors (persistent fever before bronchoscopy, extrapulmonary complications, pleural effusion, cough duration, and LDH levels) prior to bronchoscopy can be used for the early identification of RMPP-induced PB. WHAT IS KNOWN • Refractory Mycoplasma pneumoniae pneumonia (RMPP) in children has been increasingly reported and recognized, which often leads to serious complications. • Plastic bronchitis (PB) is considered to be one of the causes of RMPP, and bronchoscopic treatment should be improved as soon as possible to remove plastic sputum thrombus in bronchus. WHAT IS NEW • This study determined the risk factors for RMPP-induced PB. • The nomogram model constructed in this study prior to bronchoscopy can be used for the early identification of RMPP-induced PB, which facilitate the early bronchoscopic removal of casts, thereby promoting recovery and reducing cases with poor RMPP prognosis.
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Affiliation(s)
- Han Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Jingjing Yang
- Department of Pediatrics, Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin, 130021, China
| | - Wenqi Zhao
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Jing Zhou
- Department of Pneumology, Xinmin People's Hospital, Shenyang, 110300, Liaoning, China
| | - Shuangyu He
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Yunxiao Shang
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China
| | - Qi Cheng
- Department of Pediatrics, Shengjing Hospital of China Medical University, 36Th Sanhao Street, Heping District, Shenyang, Liaoning, 110004, People's Republic of China.
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Kimura S, Yasudo H, Oga A, Fukano R, Matsushige T, Hamano H, Hasegawa H, Nakajima N, Ainai A, Itoh H, Shirabe K, Toda S, Atsuta R, Hasegawa S. Histological characteristics of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinases-1 in asthmatic murine model during A(H1N1)pdm09 infection. Pathol Int 2022; 72:506-518. [PMID: 36066006 DOI: 10.1111/pin.13268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/09/2022] [Indexed: 11/27/2022]
Abstract
Pandemic influenza virus A(H1N1)pdm09 infection occurred in healthy children and young adults, but asthmatic patients presented more rapid progression of respiratory distress and plastic bronchitis. To investigate the pathogenesis of worsening respiratory symptoms after A(H1N1)pdm09 infection, we focused on matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinases-1 (TIMP-1). MMP-9 and TIMP-1 levels in bronchoalveolar lavage fluid and serum from mice with and without asthma were evaluated after A(H1N1)pdm09 or seasonal A(H1N1) infection. MMP-9 levels were more elevated in Asthma/A(H1N1)pdm09-infected mice than in non-Asthma/A(H1N1)pdm09-infected mice on both 3 and 7 days post-infection. Immunohistochemical findings in this pneumonia model showed that MMP-9 and TIMP-1 positive cells were observed in blood vessels and bronchus of lung tissue in severe pathological findings of pneumonia with asthma. Microscopically, shedding cells and secretions were conspicuous in the trachea on days 3 and 7 post-infection, in the A(H1N1)pdm09-infected mice with asthma. Our results suggest that MMP-9 and TIMP-1 expressions are related to severe pneumonia in the A(H1N1)pdm09 infection with asthma, leading to cause epithelial cell shedding.
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Affiliation(s)
- Sasagu Kimura
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroki Yasudo
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Atsunori Oga
- Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Reiji Fukano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takeshi Matsushige
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hiroki Hamano
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Hideki Hasegawa
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Noriko Nakajima
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Akira Ainai
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Japan
| | - Hiroshi Itoh
- Department of Pathology, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Komei Shirabe
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Shoichi Toda
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Ryo Atsuta
- Akihabara Atsuta Clinic, Chiyoda-ku, Japan
| | - Shunji Hasegawa
- Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube, Japan
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Ma Y, Gu Y, Zhang X, Gu W, Wang T, Sun H, Dai Y, Yan Y, Wang Y, Wang M, Sun H, Hao C, Fan L, Chen Z. High Expression of MUC5AC, MUC5B, and Layilin Plays an Essential Role in Prediction in the Development of Plastic Bronchitis Caused by MPP. Front Microbiol 2022; 13:911228. [PMID: 35770160 PMCID: PMC9234514 DOI: 10.3389/fmicb.2022.911228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 04/25/2022] [Indexed: 11/22/2022] Open
Abstract
Plastic bronchitis (PB) is a rare respiratory condition which can result in severe respiratory complications such as respiratory failure and death. Mycoplasma pneumoniae infection is a main etiology cause of plastic bronchitis. However, the pathogenesis of plastic bronchitis complicated by Mycoplasma pneumoniae pneumonia (MPP) has not yet been fully elucidated. Our article aims to explore biomarkers for early prediction of MPP cases complicated with plastic bronchitis. We utilized a protein chip to screen for significantly different proteins among the groups of healthy, general Mycoplasma pneumoniae pneumonia (GMPP) and refractory Mycoplasma pneumoniae pneumonia (RMPP) patients, where layilin exhibited a potent change across biology information technology. Next, we demonstrated the high expression of MUC5AC, MUC5B, and layilin in bronchoalveolar lavage fluid (BALF) of MPP cases complicated with plastic bronchitis. Further study suggested that the level of layilin had a positive correlation with both MUC5AC and MUC5B. A receiver operating characteristic (ROC) analysis was performed to assess the diagnostic values of MUC5AC, MUC5B, and layilin in MPP cases with PB. Data show that the three indicators have similar diagnostic ability for MPP children with plastic bronchitis. Then, we used different concentrations of community-acquired respiratory distress syndrome (CARDS) toxin or lipid-associated membrane proteins (LAMPs) to simulate an in vitro experiment. The in vitro assay revealed that CARDS toxin or LAMPs induced A549 cells to secrete MUC5AC, MUC5B, layilin, and proinflammatory factors. These findings suggest that MUC5AC, MUC5B, and layilin are correlated with MPP. The high expression of MUC5AC, MUC5B, and layilin play an essential role in prediction in the development of plastic bronchitis caused by MPP. The high expression of MUC5AC, MUC5B, and layilin may be relevant to the severity of illness.
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Affiliation(s)
- Yu Ma
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yeqi Gu
- Department of Pediatrics, Changzhou Wujin People's Hospital, Changzhou, China
| | - Xinxing Zhang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Wenjing Gu
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Ting Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Huiming Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yinfang Dai
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yongdong Yan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Yuqing Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Meijuan Wang
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Huiquan Sun
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Chuangli Hao
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
| | - Liping Fan
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
- Liping Fan
| | - Zhengrong Chen
- Department of Respiratory Medicine, Children's Hospital of Soochow University, Suzhou, China
- *Correspondence: Zhengrong Chen
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Nojima T, Naito H, Obara T, Tsukahara K, Nakao A. Plastic Bronchitis in a Five-Year-Old Boy Treated Using Extracorporeal Membrane Oxygenation; a Case Report. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2021. [PMID: 33870203 PMCID: PMC8035695 DOI: 10.22037/aaem.v9i1.1014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Plastic bronchitis is an uncommon disorder marked by the production of bronchial casts and acute respiratory failure development. In pediatric cases, influenza infection sometimes results in the obstruction of bronchi and leads to this potentially life-threatening condition. We report the case of a five-year-old boy with plastic bronchitis related to influenza A infection, which could only be recovered by the use of extracorporeal membrane oxygenation (ECMO). ECMO could effectively provide sufficient oxygenation for patients suffering from severe reversible acute respiratory failure. If patients infected with the influenza virus present acute respiratory distress with total lung atelectasis, clinicians should consider the diagnosis of plastic bronchitis and the subsequent treatment interventions with ECMO in a severe cases.
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Affiliation(s)
- Tsuyoshi Nojima
- Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiromichi Naito
- Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Takafumi Obara
- Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Kohei Tsukahara
- Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Atsunori Nakao
- Department of Emergency, Critical Care and Disaster Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Yuan L, Huang JJ, Zhu QG, Li MZ, Zhuo ZQ. Plastic bronchitis associated with adenovirus serotype 7 in children. BMC Pediatr 2020; 20:268. [PMID: 32493254 PMCID: PMC7268262 DOI: 10.1186/s12887-020-02119-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 05/04/2020] [Indexed: 11/20/2022] Open
Abstract
Background Plastic bronchitis is an uncommon but severe respiratory disease characterized by formation of casts in tracheobronchial tree. It can lead to airway obstruction and even respiratory failure. Case presentation Plastic bronchitis is mostly seen in both post-cardiac surgery patients, especially Fontan procedure, and infections including those caused by influenza viruses, Mycoplasma pneumoniae or tuberculosis. But it has rarely been reported to be associated with adenovirus infection. We report 2 cases of plastic bronchitis arising from adenovirus serotype 7 infection, manifested in repeated high fever, cough, and progressive dyspnea, and were diagnosed and eventually cured by bronchoscopy. Conclusions Plastic bronchitis is a rare, variable and potentially fatal disease. In the cases we described, the cause was associated with adenovirus serotype 7 and its treatment required intervention with bronchoscopy and adequate control of the underlying disease.
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Affiliation(s)
- Lin Yuan
- Department of Infectious Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), 92 Yibin Road, Huli District, Xiamen City, 361006, Fujian Province, China
| | - Jing-Jing Huang
- Department of Infectious Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), 92 Yibin Road, Huli District, Xiamen City, 361006, Fujian Province, China
| | - Qi-Guo Zhu
- Department of Infectious Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), 92 Yibin Road, Huli District, Xiamen City, 361006, Fujian Province, China
| | - Ming-Zhen Li
- Department of Infectious Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), 92 Yibin Road, Huli District, Xiamen City, 361006, Fujian Province, China
| | - Zhi-Qiang Zhuo
- Department of Infectious Diseases, Xiamen Children's Hospital (Children's Hospital of Fudan University Xiamen Branch), 92 Yibin Road, Huli District, Xiamen City, 361006, Fujian Province, China.
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[Clinical features of influenza with plastic bronchitis in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22. [PMID: 32051075 PMCID: PMC7390011 DOI: 10.7499/j.issn.1008-8830.2020.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
OBJECTIVE To study the clinical features of influenza with plastic bronchitis (PB) in children, and to improve the awareness of the diagnosis and treatment of PB caused by influenza virus. METHODS A retrospective analysis was performed for the clinical data of 70 children with lower respiratory influenza virus infection from October 2018 to October 2019. According to the presence or absence of PB, they were divided into an influenza+PB group with 12 children and a non-PB influenza group with 58 children. Related clinical data were collected for the retrospective analysis, including general information, clinical manifestations, laboratory examination, imaging findings, treatment, and prognosis. RESULTS In the influenza+PB group, most children experienced disease onset at the age of 1-5 years, with the peak months of January, February, July, and September. Major clinical manifestations in the influenza+PB group included fever, cough, and shortness of breath. The influenza+PB group had significantly higher incidence rates of shortness of breath and allergic diseases such as asthma than the non-PB influenza group (P<0.05). Of the 12 children in the influenza+PB group, 7(58%) had influenza A virus infection and 5 (42%) had influenza B virus infection, among whom 1 had nephrotic syndrome. For the children in the influenza+PB group, major imaging findings included pulmonary consolidation with atelectasis, high-density infiltration, pleural effusion, and mediastinal emphysema. Compared with the non-PB influenza group, the influenza+PB group had a significantly higher proportion of children who were admitted to the pediatric intensive care unit (P<0.05). Bronchoscopic lavage was performed within 1 week after admission, and all children were improved and discharged after anti-infective therapy and symptomatic/supportive treatment. CONCLUSIONS Influenza with PB tends to have acute onset and rapid progression, and it is important to perform bronchoscopy as early as possible. The possibility of PB should be considered when the presence of shortness of breath, allergic diseases such as asthma or nephrotic syndrome in children with influenza.
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Zhang FZ, Qin L, Yuan JX, Tang LF. Plastic bronchitis due to adenoviral infection: a case report. BMC Pediatr 2020; 20:61. [PMID: 32039717 PMCID: PMC7008568 DOI: 10.1186/s12887-020-1954-0] [Citation(s) in RCA: 8] [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: 06/30/2019] [Accepted: 02/03/2020] [Indexed: 12/12/2022] Open
Abstract
Background Plastic bronchitis (PB) frequently occurs as a serious postoperative complication of the Fontan procedure. The definitive causes of PB are unknown. Case presentation Herein, we report a pediatric case of PB secondary to adenoviral infection. A 4-year-old girl was admitted to the general pediatric ward for cough since 2 weeks and fever since 11 days. Consolidated lesions were noted in the right upper and both lower lung lobes. Extracorporeal membrane oxygenation was performed because the patient’s respiratory failure remained unalleviated despite the use of a ventilator. Bronchial dendritic casts were extracted using flexible bronchoscopy, and the patient’s breathing improved. Pathological examination of the dendritic cast confirmed the diagnosis of type I PB. The exfoliated cells of sputum and cells from bronchoalveolar lavage fluid were positive for adenoviral antigen. Human adenovirus 7 was detected by next-generation sequencing of the bronchoalveolar lavage fluid. The patient recovered and was discharged 39 days after admission without recurrence of cough or wheezing. Conclusions PB due to human adenovirus 7 infection should be considered in children with persistent respiratory failure. Flexible bronchoscopy should be performed early to confirm diagnosis and to remove any airway obstruction.
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Affiliation(s)
- Fei Zhou Zhang
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China
| | - Lu Qin
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China
| | - Jie Xin Yuan
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China
| | - Lan Fang Tang
- Zhejiang University School of Medicine of Children's Hospital, 3333 Binsheng Road, Hangzhou, 310051, China.
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Yang Q, Bao YM, Yi QW, Wang W, Zheng YJ. [Clinical features of influenza with plastic bronchitis in children]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2020; 22:106-111. [PMID: 32051075 PMCID: PMC7390011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 01/16/2020] [Indexed: 11/12/2023]
Abstract
OBJECTIVE To study the clinical features of influenza with plastic bronchitis (PB) in children, and to improve the awareness of the diagnosis and treatment of PB caused by influenza virus. METHODS A retrospective analysis was performed for the clinical data of 70 children with lower respiratory influenza virus infection from October 2018 to October 2019. According to the presence or absence of PB, they were divided into an influenza+PB group with 12 children and a non-PB influenza group with 58 children. Related clinical data were collected for the retrospective analysis, including general information, clinical manifestations, laboratory examination, imaging findings, treatment, and prognosis. RESULTS In the influenza+PB group, most children experienced disease onset at the age of 1-5 years, with the peak months of January, February, July, and September. Major clinical manifestations in the influenza+PB group included fever, cough, and shortness of breath. The influenza+PB group had significantly higher incidence rates of shortness of breath and allergic diseases such as asthma than the non-PB influenza group (P<0.05). Of the 12 children in the influenza+PB group, 7(58%) had influenza A virus infection and 5 (42%) had influenza B virus infection, among whom 1 had nephrotic syndrome. For the children in the influenza+PB group, major imaging findings included pulmonary consolidation with atelectasis, high-density infiltration, pleural effusion, and mediastinal emphysema. Compared with the non-PB influenza group, the influenza+PB group had a significantly higher proportion of children who were admitted to the pediatric intensive care unit (P<0.05). Bronchoscopic lavage was performed within 1 week after admission, and all children were improved and discharged after anti-infective therapy and symptomatic/supportive treatment. CONCLUSIONS Influenza with PB tends to have acute onset and rapid progression, and it is important to perform bronchoscopy as early as possible. The possibility of PB should be considered when the presence of shortness of breath, allergic diseases such as asthma or nephrotic syndrome in children with influenza.
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Affiliation(s)
- Qin Yang
- Department of Respiratory Medicine, Shenzhen Children's Hospital, Shenzhen, Guangdong 518026, China.
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11
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Kirito Y, Matsubayashi T, Ohsugi K. Plastic bronchitis: Three cases caused by influenza B virus Yamagata lineage. Pediatr Int 2019; 61:421-423. [PMID: 30983073 DOI: 10.1111/ped.13799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/27/2018] [Accepted: 02/05/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yuki Kirito
- Department of Pediatrics, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Tadashi Matsubayashi
- Department of Pediatrics, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
| | - Koichi Ohsugi
- Department of Emergency and Critical Care Medicine, Seirei Hamamatsu General Hospital, Hamamatsu City, Shizuoka, Japan
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12
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Sera T, Hamamoto T, Tani H, Ono D, Ueda T, Takeno S. A Case of Plastic Bronchitis that Required Differential Diagnosis from Bronchial Foreign Body. ACTA ACUST UNITED AC 2018. [DOI: 10.2468/jbes.69.255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Takehiro Sera
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University
| | - Takao Hamamoto
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University
| | - Hiroo Tani
- Department of Pediatrics, Graduate School of Biomedical Sciences, Hiroshima University
| | - Daichi Ono
- Department of Pediatrics, Graduate School of Biomedical Sciences, Hiroshima University
| | - Tsutomu Ueda
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University
| | - Sachio Takeno
- Department of Otolaryngology, Head and Neck Surgery, Graduate School of Biomedical Sciences, Hiroshima University
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13
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A Case of Plastic Bronchitis Associated Influenza A Pneumonia Requiring ECMO Assistance. ACTA ACUST UNITED AC 2018. [DOI: 10.14776/piv.2018.25.e4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Nogan SJ, Cass ND, Wiet GJ, Ruda JM. Plastic bronchitis arising from solitary influenza B infection: A report of two cases in children. Int J Pediatr Otorhinolaryngol 2015; 79:1140-4. [PMID: 25957780 DOI: 10.1016/j.ijporl.2015.03.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 03/22/2015] [Accepted: 03/28/2015] [Indexed: 11/25/2022]
Abstract
Plastic bronchitis (PB) is characterized by thick, inspissated, tracheobronchial casts. It is classified as either inflammatory or acellular based on the content of the endobronchial casts. PB has never been reported in a healthy child with solitary influenza B infection. This study is a retrospective case series of two children who presented to our institution in acute respiratory distress. Emergency rigid bronchoscopy was performed with extraction of casts from the L mainstem bronchus in both patients. Influenza B was the only isolate identified. In otherwise healthy children with respiratory distress, influenza B-mediated inflammatory PB must be considered in the differential diagnosis.
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Affiliation(s)
- Stephen J Nogan
- Department of Otolaryngology-Head & Neck Surgery, Ohio State University-Wexner Medical Center, Columbus, OH 43212, USA.
| | - Nathan D Cass
- Department of Otolaryngology, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA.
| | - Gregory J Wiet
- Department of Otolaryngology-Head & Neck Surgery, Ohio State University-Wexner Medical Center, Columbus, OH 43212, USA; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH 43205, USA.
| | - James M Ruda
- Department of Otolaryngology-Head & Neck Surgery, Ohio State University-Wexner Medical Center, Columbus, OH 43212, USA; Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, OH 43205, USA.
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15
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Zhang J, Kang X. Response to the Letter to editor regarding "Plastic bronchitis associated with influenza virus infection in children: a report on 14 cases". Int J Pediatr Otorhinolaryngol 2015; 79:782. [PMID: 25769810 DOI: 10.1016/j.ijporl.2015.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Jianhui Zhang
- Guangzhou Women and Children's Medical Center, China.
| | - Xiaolei Kang
- Guangzhou Women and Children's Medical Center, China
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16
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Joob B, Wiwanitkit V. Letter to the editor regarding "Plastic bronchitis associated with influenza". Int J Pediatr Otorhinolaryngol 2015; 79:777. [PMID: 25770645 DOI: 10.1016/j.ijporl.2015.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Accepted: 02/18/2015] [Indexed: 11/25/2022]
Affiliation(s)
- Beuy Joob
- Sanitation 1 Medical Academic Center, Bangkok, Thailand.
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17
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Zhang J, Kang X. Plastic bronchitis associated with influenza virus infection in children: a report on 14 cases. Int J Pediatr Otorhinolaryngol 2015; 79:481-6. [PMID: 25639552 DOI: 10.1016/j.ijporl.2015.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 12/29/2014] [Accepted: 01/08/2015] [Indexed: 10/24/2022]
Abstract
BACKGROUND Plastic bronchitis (PB) is a rare disease characterized by formation of bronchial casts. It is usually associated with congenital heart disease, sickle cell disease, lymphoma, and lung diseases such as asthma and pneumonia. OBJECTIVES To report 14 cases of PB with influenza A or influenza B infection. METHODS We analyzed the clinical manifestations, bronchoscopic and histologic findings, clinical courses, and outcomes. RESULTS These cases indicate that PB is a life-threatening complication of severe influenza. Plastic bronchitis should be considered in the diagnosis of children with acute respiratory distress such as lung atelectasis accompanied by influenza. CONCLUSIONS Diagnosis should be made by bronchial endoscopy and histopathology, and bronchial casts removed as early as possible.
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Affiliation(s)
- Jianhui Zhang
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou, China.
| | - Xiaolei Kang
- Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, 9 Jinsui Road, Guangzhou, China
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