title: Pediatric plastic bronchitis: case report and retrospective comparative analysis of epidemiology and pathology.
abstract: Plastic bronchitis (PB) is a pathologic condition in which airway casts develop in the tracheobronchial tree causing airway obstruction. There is no standard treatment strategy for this uncommon condition. We report an index patient treated using an emerging multimodal strategy of directly instilled and inhaled tissue plasminogen activator (t-PA) as well as 13 other cases of PB at our institution between 2000 and 2012. The majority of cases (n = 8) occurred in patients with congenital heart disease. Clinical presentations, treatments used, histopathology of the casts, and patient outcomes are reviewed. Further discussion is focused on the epidemiology of plastic bronchitis and a systematic approach to the histologic classification of casts. Comorbid conditions identified in this study included congenital heart disease (8), pneumonia (3), and asthma (2). Our institutional prevalence rate was 6.8 per 100,000 patients, and our case fatality rate was 7%.
authors: Departments of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
authors: Rebecca
authors: R
authors: Kunder
authors: Christian
authors: C
authors: Kunder
authors: Heather Y
authors: HY
authors: Sun
authors: Gerald
authors: G
authors: Berry
authors: Anna
authors: A
authors: Messner
authors: Jennifer
authors: J
authors: Frankovich
authors: Stephen
authors: S
authors: Roth
authors: John
authors: J
authors: Mark
references: Pediatr Cardiol. 2009 Apr;30(3):352-5
references: 19005718
references: Pediatrics. 2002 Apr;109(4):e67
references: 11927740
references: Pediatr Crit Care Med. 2005 Jan;6(1):76-8
references: 15636664
references: Arch Dis Child. 2003 Jul;88(7):626-7
references: 12818912
references: Pediatr Pulmonol. 1999 Nov;28(5):329-36
references: 10536063
references: Am J Respir Crit Care Med. 1997 Jan;155(1):364-70
references: 9001337
references: Am J Cardiol. 2003 Apr 15;91(8):1031-2, A9
references: 12686359
references: Pediatr Cardiol. 2002 Mar-Apr;23(2):146-51
references: 11889524
references: Circulation. 2001 Feb 20;103(7):1031-3
references: 11181481
references: Pediatr Crit Care Med. 2009 May;10(3):e34-6
references: 19433939
references: Pediatr Cardiol. 2011 Dec;32(8):1182-9
references: 21786171
references: Pediatr Cardiol. 2008 Jan;29(1):157-9
references: 17929079
references: Crit Care Med. 2000 Jun;28(6):2107-11
references: 10890673
references: Arch Otolaryngol Head Neck Surg. 2011 Apr;137(4):401-3
references: 21502481
references: Pediatr Radiol. 2008 Sep;38(9):989-93
references: 18629486
references: Pneumologie. 2004 Jun;58(6):443-8
references: 15216438
references: Pediatrics. 2012 Aug;130(2):e446-50
references: 22802609
references: Paediatr Respir Rev. 2005 Dec;6(4):292-300
references: 16298313
references: Pediatr Pulmonol. 2002 Dec;34(6):482-7
references: 12422347
references: Am J Med Sci. 2008 Feb;335(2):163-9
references: 18277130
references: Int J Pediatr Otorhinolaryngol. 2010 Jan;74(1):15-21
references: 19880198
references: Pediatr Cardiol. 2013 Feb;34(2):256-61
references: 22797520