Use of montelukast in the treatment of early childhood wheezing from clinical experience with three cases.
Leukotrienes were found to be raised in respiratory syncytial virus bronchiolitis. Montelukast is a cysteinyl leukotrienes antagonist. We report our experience with the use of montelukast in three young children from 5-months to 20-months old. The first case was a 5-month-old boy with previous good health. He had prolonged respiratory distress secondary to adenovirus type 3 infection. The second case was a 20-month-old boy with bronchopulmonary dysplasia. He had respiratory syncytial virus and an adenovirus type 3 infection leading to prolonged wheeze. The third case was a 20-month-old girl with chronic lung disorder after an episode of severe E. coli pneumonia at 1 month old. She developed acute virus-negative severe wheeze after a few days of running nose and low-grade fever. All three cases responded poorly to inhaled steroids and bronchodilators. Addition of montelukast was associated with marked clinical improvement within 1 week. The three cases were very heterogeneous and differed from usual simple virus-induced acute bronchiolitis. The use of multiple drugs including montelukast did not enable any definite conclusions; however, the addition of montelukast was closely related to clinical improvement. Further studies in the use of montelukast in severe virus-induced bronchiolitis are warranted.
Ng
D K
DK
Department of Paediatrics, Kwong Wah Hospital, Hong Kong, China. dkkng@ha.org.hk
Law
A K
AK
Chau
K W
KW
Chan
H K
HK
D000085:Acetates / Q000494:pharmacology / Q000627:therapeutic use*; D000208:Acute Disease; D000367:Age Factors; D001990:Bronchiolitis, Viral / Q000188:drug therapy* / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D003521:Cyclopropanes; D005260:Female; D006801:Humans; D007223:Infant; D020024:Leukotriene Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D015289:Leukotrienes / Q000276:immunology; D008297:Male; D011804:Quinolines / Q000494:pharmacology / Q000627:therapeutic use*; D012135:Respiratory Sounds / Q000187:drug effects* / Q000276:immunology; D013440:Sulfides; D016896:Treatment Outcome
D000085:Acetates; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D015289:Leukotrienes; D011804:Quinolines; D013440:Sulfides; C093875:montelukast