title: Fontan patient with plastic bronchitis treated successfully using aerosolized tissue plasminogen activator: a case report and review of the literature.
abstract: Plastic bronchitis is an uncommon condition characterized by the production of large pale bronchial casts that obstruct the tracheobronchial tree. The cellular content, cohesiveness, and often rubber-like consistency distinguish bronchial casts from the usual mucus plugs found with such disease states as asthma. Plastic bronchitis can be found secondary to many conditions, and a simplified classification scheme organizes it into two groups: an inflammatory type consisting of casts with an eosinophilic inflammatory infiltrate and an acellular type with a predominance of fibrin distinguished by its relative lack of cellular infiltrate, its mucin predominance, and its appearance only in children with congenital cyanotic heart disease. This report describes a 5-year-old girl who experienced plastic bronchitis 3 months after a Fontan procedure for hypoplastic left heart syndrome that was treated successfully with aerosolized tissue plasminogen activator.
authors.affiliation: Children's Hospital of Orange County, Orange, CA 92868, USA. tdo@choc.org
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Do
authors.forename: James M
authors.initials: JM
authors.lastname: Chu
authors.forename: Farhouch
authors.initials: F
authors.lastname: Berdjis
authors.forename: Nick G
authors.initials: NG
authors.lastname: Anas
mesh_terms: D000280:Administration, Inhalation; D001991:Bronchitis / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D001999:Bronchoscopy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D018729:Fontan Procedure / Q000379:methods*; D006801:Humans; D018636:Hypoplastic Left Heart Syndrome / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D013902:Radiography, Thoracic; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator