GP283 Clinical and radiological evaluation of patients with postinfectious bronchiolitis obliterans. (June 2019)

• Record Type: Journal Article
• Authors: Cakir, Erkan; Khalif, Fatouma; Bilgin, Mehmet; Shadfan, Lina Al; Yazan, Hakan; Yilmaz, Irem; Nursoy, Mustafa Atilla
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 3
• Page Start: A149
• Page End: A149
• Publication Date: 2019-06
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-epa.342
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Introduction: Postinfectious bronchiolitis obliterans is characterized by persistent symptoms and signs of obstructive pulmonary disease following acute bronchial injury. It usually occurs with persistent wheezing and cough as a result of severe viral infections. The aim of this study was to investigate the socio-demographic characteristics, treatment status, and clinical response of our cases of postinfectious bronchiolitis obliterans. Methods: The records of 102 patients with postinfectious bronchiolitis obliterans who were followed-up in our clinic were retrospectively reviewed. Sociodemographic characteristics, treatments, pre-treatment and post-treatment complaints, pulmonary function tests, clinical status, radiological changes were evaluated. Results: 68.6% (n = 70) of our patients were male. The mean age of the patients at the time of the study was 88.8 ± 53.5 months, and the age of diagnosis was 34.3 ± 36.4 months. The mean period from the first complaints to the date of diagnosis was 22.8 ± 33.8 months. 59% (57) of the patients had a history of smoking in one of their parents. In 62.7% of the cases, the first lower respiratory tract infection was bronchopneumonia and 36.3% was in the acute bronchiolitis. Before the diagnosis, 35 patients had intensive care hospitalization (34.3%). Persistent cough (90.2%), wheezing (96.1%), shortness of breath (91.2%) and purulant cough (75%) were the most frequent findings. When treatments of the patients were evaluated; inhaled corticosteroids were 92.2%, 6 months azithromycin 69.6%, 6 months oral steroid 61.8%. 11 patients (10.8%) needed oxygen and 10 patients (9.8%) required Bilevel Positive Airway Pressure (BPAP) support. Before and after treatment of 49 patients, lung CTs were evaluated by radiologist and modified Bhalla scores were calculated. Pre-treatment mosaism and peribronchial thickening were detected in all patients. There were bronchiectasis 67.3%, atelectasis 91.8%, hyperinflation 81.6%, air trapping 98% of patients. Post-treatment radiological evaluation revealed mosaism 93.9%, peribronchial thickening 100%, bronchiectasis 51%, atelectasis 65.3%, hyperinflation 69.4%, air trapping 87.8%. The mean Bhalla score was 9.1 ± 4.1 before the treatment and it was found to be 6.8 ± 4.6 after treatment. Discussion and Conclusion: Postinfectious bronchiolitis obliterans is a rare condition with obstruction findings. It occurs as a result of immune mechanisms after severe lung infection, especially at a young age. In this study, we aimed to present sociodemographic characteristics, clinical features and especially response to long-term sterolid and azithromycin treatment in patients with bronchiolitis obliterans.