Cargando…
Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital
BACKGROUND: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. OBJECTIVE: The objective of the study is to describe the clinical profile and course of children diagnosed wit...
Autores principales: | , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer - Medknow
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961095/ https://www.ncbi.nlm.nih.gov/pubmed/31898614 http://dx.doi.org/10.4103/lungindia.lungindia_145_19 |
_version_ | 1783487921423122432 |
---|---|
author | Gulla, Krishna Mohan Jat, Kana Ram Lodha, Rakesh Kabra, Sushil K |
author_facet | Gulla, Krishna Mohan Jat, Kana Ram Lodha, Rakesh Kabra, Sushil K |
author_sort | Gulla, Krishna Mohan |
collection | PubMed |
description | BACKGROUND: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. OBJECTIVE: The objective of the study is to describe the clinical profile and course of children diagnosed with PIBO. METHODS: A chart review of children below 18 years of age diagnosed as PIBO over the past 9 years was carried out. Details of clinical profile, laboratory investigations, imaging, treatment received, and outcome were recorded. RESULTS: Eight children (boys 4) with PIBO were identified. Median (interquartile range [IQR]) age at the first episode of acute severe bronchiolitis such as illness and diagnosis of PIBO was 15 (6, 23.5) and 30 (16.5, 60) months, respectively, indicating a delay in diagnosis. The most common symptoms were recurrent episodes of cough (100%), fast breathing (100%), wheezing (87.5%), and fever (62.5%). Median (IQR) number of hospitalizations and episodes of antibiotic use prior to diagnosis were 2.5 (2, 5.5) and 2 (2, 4), respectively. Three (37.5%) children received mechanical ventilation during previous hospitalizations. Chest computed tomography revealed mosaic attenuation in 8 (100%), ground-glass opacities in 2 (25%), and bronchial wall thickening in 2 (25%). After diagnosis, 7 received oral steroids, 7 received hydroxychloroquine, 5 received azithromycin, and 2 received azathioprine. The median (IQR) duration of follow-up (n = 6) was 6 (1.5, 9.5) months. Median (IQR) number of pulmonary exacerbations in follow-up was 2 (1, 5). CONCLUSION: PIBO is still an under-recognized entity with substantial delay in diagnosis and unnecessary use of antibiotics. Clinical course with imaging findings may help to diagnose and manage this entity. |
format | Online Article Text |
id | pubmed-6961095 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Wolters Kluwer - Medknow |
record_format | MEDLINE/PubMed |
spelling | pubmed-69610952020-01-16 Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital Gulla, Krishna Mohan Jat, Kana Ram Lodha, Rakesh Kabra, Sushil K Lung India Original Article BACKGROUND: Postinfectious bronchiolitis obliterans (PIBO) is a chronic obstructive lung disease with scanty information in literature on etiology, clinical profile, treatment, and outcome. OBJECTIVE: The objective of the study is to describe the clinical profile and course of children diagnosed with PIBO. METHODS: A chart review of children below 18 years of age diagnosed as PIBO over the past 9 years was carried out. Details of clinical profile, laboratory investigations, imaging, treatment received, and outcome were recorded. RESULTS: Eight children (boys 4) with PIBO were identified. Median (interquartile range [IQR]) age at the first episode of acute severe bronchiolitis such as illness and diagnosis of PIBO was 15 (6, 23.5) and 30 (16.5, 60) months, respectively, indicating a delay in diagnosis. The most common symptoms were recurrent episodes of cough (100%), fast breathing (100%), wheezing (87.5%), and fever (62.5%). Median (IQR) number of hospitalizations and episodes of antibiotic use prior to diagnosis were 2.5 (2, 5.5) and 2 (2, 4), respectively. Three (37.5%) children received mechanical ventilation during previous hospitalizations. Chest computed tomography revealed mosaic attenuation in 8 (100%), ground-glass opacities in 2 (25%), and bronchial wall thickening in 2 (25%). After diagnosis, 7 received oral steroids, 7 received hydroxychloroquine, 5 received azithromycin, and 2 received azathioprine. The median (IQR) duration of follow-up (n = 6) was 6 (1.5, 9.5) months. Median (IQR) number of pulmonary exacerbations in follow-up was 2 (1, 5). CONCLUSION: PIBO is still an under-recognized entity with substantial delay in diagnosis and unnecessary use of antibiotics. Clinical course with imaging findings may help to diagnose and manage this entity. Wolters Kluwer - Medknow 2020 2019-12-31 /pmc/articles/PMC6961095/ /pubmed/31898614 http://dx.doi.org/10.4103/lungindia.lungindia_145_19 Text en Copyright: © 2019 Indian Chest Society http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. |
spellingShingle | Original Article Gulla, Krishna Mohan Jat, Kana Ram Lodha, Rakesh Kabra, Sushil K Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title | Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_full | Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_fullStr | Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_full_unstemmed | Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_short | Clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
title_sort | clinical profile and course of children with postinfectious bronchiolitis obliterans from a tertiary care hospital |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961095/ https://www.ncbi.nlm.nih.gov/pubmed/31898614 http://dx.doi.org/10.4103/lungindia.lungindia_145_19 |
work_keys_str_mv | AT gullakrishnamohan clinicalprofileandcourseofchildrenwithpostinfectiousbronchiolitisobliteransfromatertiarycarehospital AT jatkanaram clinicalprofileandcourseofchildrenwithpostinfectiousbronchiolitisobliteransfromatertiarycarehospital AT lodharakesh clinicalprofileandcourseofchildrenwithpostinfectiousbronchiolitisobliteransfromatertiarycarehospital AT kabrasushilk clinicalprofileandcourseofchildrenwithpostinfectiousbronchiolitisobliteransfromatertiarycarehospital |