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Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases
BACKGROUND: With an increase in the diagnosis of plastic bronchitis (PB) cases, to enhance paediatricians’ knowledge and add to the few existing studies, we explored the clinical characteristics, diagnosis, and treatment of PB in children. METHODS: The clinicopathological data of 43 children admitte...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898471/ https://www.ncbi.nlm.nih.gov/pubmed/35248022 http://dx.doi.org/10.1186/s12931-022-01975-1 |
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author | Huang, Jing-jing Yang, Xiao-qing Zhuo, Zhi-qiang Yuan, Lin |
author_facet | Huang, Jing-jing Yang, Xiao-qing Zhuo, Zhi-qiang Yuan, Lin |
author_sort | Huang, Jing-jing |
collection | PubMed |
description | BACKGROUND: With an increase in the diagnosis of plastic bronchitis (PB) cases, to enhance paediatricians’ knowledge and add to the few existing studies, we explored the clinical characteristics, diagnosis, and treatment of PB in children. METHODS: The clinicopathological data of 43 children admitted to the Xiamen Children’s Hospital and the Women and Children’s Hospital, affiliated to the Xiamen University from December 2016 to December 2019, were retrospectively analysed. RESULTS: All the children had cough, with 41 of them having associated fever. A peak temperature > 40 ℃ was observed in 25 children. Twenty-six children had shortness of breath, 27 had reduced respiratory sounds on the affected side, and 35 had audible moist rales on the affected side. Lactate dehydrogenase in all children increased to different degrees, and 29 had elevated D-dimer and fibrinogen degradation products. Lung imaging showed pulmonary consolidation and atelectasis, mainly in the bilateral lower lung lobes, in all the children. However, 31 had pleural effusion, mainly a small parapneumonic effusion. The infections were mainly caused by adenovirus and Mycoplasma pneumoniae. The casts in all 43 children were sucked or clamped out under bronchoscopy, and 10 were found to have type I PB on pathological examination. All children were treated with anti-infective therapy in addition to bronchoscopic cast removal. Thirty-one children were treated with methylprednisolone, and 16 with gamma globulin. Except for one child who was non-adherent to treatment, all other children showed improvement, or were cured and discharged from the hospital. Follow-up lung imaging at 3 months revealed that the lungs were fully re-expanded in 40 children. At the 6-month follow-up, six children had small airway lesions, four had obliterative bronchiolitis, and one had bronchiectasis. CONCLUSIONS: Paediatric PB often occurs secondary to respiratory tract infections and progresses rapidly, with hyperpyrexia, cough, and shortness of breath as the main clinical manifestations. Pulmonary consolidation, atelectasis, and pleural effusion are seen on lung imaging, and early bronchoscopy and removal of casts in the trachea and bronchi are effective treatment options. |
format | Online Article Text |
id | pubmed-8898471 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-88984712022-03-17 Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases Huang, Jing-jing Yang, Xiao-qing Zhuo, Zhi-qiang Yuan, Lin Respir Res Research BACKGROUND: With an increase in the diagnosis of plastic bronchitis (PB) cases, to enhance paediatricians’ knowledge and add to the few existing studies, we explored the clinical characteristics, diagnosis, and treatment of PB in children. METHODS: The clinicopathological data of 43 children admitted to the Xiamen Children’s Hospital and the Women and Children’s Hospital, affiliated to the Xiamen University from December 2016 to December 2019, were retrospectively analysed. RESULTS: All the children had cough, with 41 of them having associated fever. A peak temperature > 40 ℃ was observed in 25 children. Twenty-six children had shortness of breath, 27 had reduced respiratory sounds on the affected side, and 35 had audible moist rales on the affected side. Lactate dehydrogenase in all children increased to different degrees, and 29 had elevated D-dimer and fibrinogen degradation products. Lung imaging showed pulmonary consolidation and atelectasis, mainly in the bilateral lower lung lobes, in all the children. However, 31 had pleural effusion, mainly a small parapneumonic effusion. The infections were mainly caused by adenovirus and Mycoplasma pneumoniae. The casts in all 43 children were sucked or clamped out under bronchoscopy, and 10 were found to have type I PB on pathological examination. All children were treated with anti-infective therapy in addition to bronchoscopic cast removal. Thirty-one children were treated with methylprednisolone, and 16 with gamma globulin. Except for one child who was non-adherent to treatment, all other children showed improvement, or were cured and discharged from the hospital. Follow-up lung imaging at 3 months revealed that the lungs were fully re-expanded in 40 children. At the 6-month follow-up, six children had small airway lesions, four had obliterative bronchiolitis, and one had bronchiectasis. CONCLUSIONS: Paediatric PB often occurs secondary to respiratory tract infections and progresses rapidly, with hyperpyrexia, cough, and shortness of breath as the main clinical manifestations. Pulmonary consolidation, atelectasis, and pleural effusion are seen on lung imaging, and early bronchoscopy and removal of casts in the trachea and bronchi are effective treatment options. BioMed Central 2022-03-06 2022 /pmc/articles/PMC8898471/ /pubmed/35248022 http://dx.doi.org/10.1186/s12931-022-01975-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Huang, Jing-jing Yang, Xiao-qing Zhuo, Zhi-qiang Yuan, Lin Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
title | Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
title_full | Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
title_fullStr | Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
title_full_unstemmed | Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
title_short | Clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
title_sort | clinical characteristics of plastic bronchitis in children: a retrospective analysis of 43 cases |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8898471/ https://www.ncbi.nlm.nih.gov/pubmed/35248022 http://dx.doi.org/10.1186/s12931-022-01975-1 |
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