title: [Plastic bronchitis in a child with thalassemia alpha].
abstract: OBJECTIVE
  Plastic bronchitis is an unusual condition in children, associated with formation of mucofibrinous casts and mucous plugging of the tracheobronchial tree. Given that this illness is part of the differential diagnosis of acute respiratory failure, early treatment is important for improved prognosis. The aim of this report is to describe a case of plastic bronchitis in a child with alpha-thalassemia that was treated successfully with endoscopy.
  
  
  METHODS
  A three year old, black, male child, previously healthy, presented with acute respiratory failure and a chest x-ray showing pulmonary atelectasis. There was no evidence of respiratory symptoms or previous allergy state. The diagnosis of plastic bronchitis was made using flexible and rigid bronchoscopy, and confirmed by histopathologic findings. The child progressed well, treatment was based on supportive care and antibiotics were not used. Ten days after discharge, radiographic appearance was normal. Alpha thalassemia was diagnosed through hemoglobin electrophoresis.
  
  
  CONCLUSIONS
  Plastic bronchitis is clinically important because has similar presentation to other prevalent diseases, such as foreign body aspiration and asthma. When plastic bronchitis is suspected, endoscopy is indicated in order to confirm diagnosis and define treatment. Plastic bronchitis has been previously described in patients with cystic fibrosis, cardiac surgery and sickle cell disease. In this case, an association with alpha-thalassemia was observed.
authors.affiliation: Pneumologia Pediátrica, Hospital São Lucas, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), CEP 90610-000 Porto Alegre, RS, Brazil.
authors.forename: Tiago N
authors.initials: TN
authors.lastname: Veras
authors.forename: Gustavo M
authors.initials: GM
authors.lastname: Lannes
authors.forename: Jefferson P
authors.initials: JP
authors.lastname: Piva
authors.forename: Renato T
authors.initials: RT
authors.lastname: Stein
authors.forename: Marcus H
authors.initials: MH
authors.lastname: Jones
authors.forename: Vinicius D
authors.initials: VD
authors.lastname: Silva
authors.forename: Pedro Celiny Ramos
authors.initials: PC
authors.lastname: Garcia
authors.forename: Paulo M C
authors.initials: PM
authors.lastname: Pitrez
mesh_terms: D001991:Bronchitis / Q000175:diagnosis* / Q000628:therapy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005547:Foreign Bodies / Q000175:diagnosis; D006801:Humans; D008297:Male; D012131:Respiratory Insufficiency / Q000175:diagnosis; D017085:alpha-Thalassemia / Q000175:diagnosis*