Clinical, radiological, and physiological differences between obliterative bronchiolitis and problematic severe asthma in adolescents and young adults: the early origins of the overlap syndrome?
OBJECTIVE
Few reports have compared chronic obstructive lung diseases (OLDs) starting in childhood.


OBJECTIVE
To describe functional, radiological, and biological features of obliterative bronchiolitis (OB) and further discriminate to problematic severe asthma (PSA) or to diagnose a group with overlapping features.


RESULTS
Patients with OB showed a greater degree of obstructive lung defect and higher hyperinflation (P < 0.001). The most frequent high-resolution computed tomography (HRCT) features (increased lung volume, inspiratory decreased attenuation, mosaic pattern, and expiratory air trapping) showed significantly greater scores in OB patients. Patients with PSA have shown a higher frequency of atopy (P < 0.05). ROC curve analysis demonstrated discriminative power for the LF variables, HRCT findings and for atopy between diagnoses. Further analysis released five final variables more accurate for the identification of a third diagnostic group (FVC%t, post-bronchodilator ΔFEV(1) in ml, HRCT mosaic pattern, SPT, and D. pteronyssinus-specific IgE).


CONCLUSIONS
We found that OB and PSA possess identifiable characteristic features but overlapping values may turn them undistinguishable.
Pediatric Department, Medical School at University of Lisbon, Hospital Santa Maria, Lisbon, Portugal. teresa.bandeira@hsm.min-saude.pt
Teresa
T
Bandeira
Filipa
F
Negreiro
Rosário
R
Ferreira
Marisa
M
Salgueiro
Luísa
L
Lobo
Pedro
P
Aguiar
J C
JC
Trindade
D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D055815:Young Adult