Postinfectious bronchiolitis obliterans in children: clinical and radiological profile and prognostic factors.
BACKGROUND
Postinfectious bronchiolitis obliterans (BO) designates a clinical syndrome of chronic airflow obstruction associated with inflammatory changes in the small airways.


OBJECTIVE
The aim of this study was to determine the etiology, clinical and radiological features and define prognostic factors of postinfectious BO in children.


METHODS
We undertook a review of the medical records of 20 children with postinfectious BO, who were followed up between January 1994 and August 2001.


RESULTS
Postinfectious BO was diagnosed in 11 boys and 9 girls with a median age of 21.5 months (6-69 months) who were followed up for a median of 23 months. Cough and wheezing persisted since the initial lung infection in all patients. Postinfectious BO was diagnosed in an average of 6 months (1-42 months) after the acute illness. Adenoviruses were the most common etiologic agents identified serologically. The diagnoses of postinfectious BO was made by thoracic high-resolution computed tomography and clinical features. Corticosteroid therapy was used in 17 patients and supportive treatment was applied in all patients. Age at initial lung infection, gender, time of starting corticosteroid treatment, presence of bronchiectasis or atelectasis and etiologic agents identified on presentation did not predict severity in our study.


CONCLUSIONS
Despite the prominent role of inflammation in the pathogenesis of postinfectious BO, the use of anti-inflammatory agents remains controversial. We could not identify any prognostic factors related to disease severity. In order to minimize associated complications, patients with postinfectious BO should be closely followed up and receive meticulous lung care.
D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D002675:Child, Preschool; D002738:Chloroquine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007239:Infections / Q000150:complications*; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D011379:Prognosis; D019233:Retreatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D002738:Chloroquine; D011239:Prednisolone