title: Plastic bronchitis and the role of bronchoscopy in the acute chest syndrome of sickle cell disease.
abstract: OBJECTIVE
  To review the prevalence, clinical features, and role of bronchoscopy in patients with plastic bronchitis during the acute chest syndrome (ACS) of sickle cell disease (SCD).
  
  
  METHODS
  Eight-year review of clinical experience.
  
  
  METHODS
  Tertiary referral children's hospital.
  
  
  METHODS
  Twenty-six pediatric inpatients with 29 ACS episodes requiring diagnostic bronchoscopy.
  
  
  RESULTS
  Of the pediatric inpatients with ACS who underwent bronchoscopy, plastic bronchitis was diagnosed in 21 of 29 episodes (72%). There was no difference in clinical features between the patients with and without plastic bronchitis. Bronchoscopy was an essential diagnostic tool, but its therapeutic benefits were doubtful.
  
  
  CONCLUSIONS
  This is the first report of the prevalence of plastic bronchitis in patients with ACS of SCD. In our patient population, this condition was found to be common. The role of diagnostic bronchoscopy is essential. A large series, multicenter study is required to determine whether bronchoscopy and BAL are therapeutically beneficial when added to currently practiced supportive care.
authors.affiliation: Pediatric Pulmonology, The Miller Children's at Long Beach Memorial Medical Center, Long Beach, CA 90806, USA.
authors.forename: C
authors.initials: C
authors.lastname: Moser
authors.forename: E
authors.initials: E
authors.lastname: Nussbaum
authors.forename: D M
authors.initials: DM
authors.lastname: Cooper
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000755:Anemia, Sickle Cell / Q000150:complications*; D001991:Bronchitis / Q000175:diagnosis*; D001992:Bronchoalveolar Lavage Fluid; D001999:Bronchoscopy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging; D008297:Male; D011859:Radiography