Bronchiolitis obliterans in children: clinical profile and diagnosis.
OBJECTIVE
The aim of the study was to determine the clinical profile, aetiology and radiological categories in children diagnosed with bronchiolitis obliterans (BO).


METHODS
We undertook a review of the medical records and radiological studies of 14 children with BO.


RESULTS
Unresolving cough and wheeze after a short respiratory illness was the commonest presentation. A viral pneumonitis was identified as the initial respiratory event prior to the development of BO in six children and Mycoplasma pneumoniae was the cause in another three children. Chest X-ray findings could be divided into four distinct patterns that were hyperinflation (n=5), mixed pattern of atelectasis, hyperlucency and bronchial thickening (n=4), unilateral small hyperlucent lung (n=3) and unilateral collapse of one lung (n=2). High resolution computed tomogram (HRCT) chest showing areas of hyperaeration and mosaic ground glass patterns with bronchial thickening were commonly found in patients whose chest X-ray showed bilateral changes. Patients with bilateral lung changes were more likely to have failure to thrive and persistent respiratory symptoms on follow up.


CONCLUSIONS
A diagnosis of BO can be made from typical clinical features combined with an understanding of the different chest X-ray categories and HRCT of the chest. A viral aetiology was the commonest cause for BO in our series.
Chan
P W
PW
Department of Paediatrics, University Malaya Medical Centre, Kuala Lumpur, Malaysia. patrick@medicine.med.um.edu.my
Muridan
R
R
Debruyne
J A
JA
D000293:Adolescent; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging* / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000209:etiology; D005183:Failure to Thrive / Q000209:etiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D008296:Malaysia; D008297:Male; D011014:Pneumonia / Q000150:complications / Q000382:microbiology; D012135:Respiratory Sounds / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed