title: Bronchiolitis obliterans: clinical and radiological profile of children followed-up in a reference outpatient clinic.
abstract: OBJECTIVE
  To describe the clinical and radiological characteristics of patients with bronchiolitis obliterans.
  
  
  METHODS
  This is a retrospective and descriptive study. Data were collected from patients diagnosed with bronchiolitis obliterans between 2004 and 2008 in the Pediatric Pulmonology Clinic of Hospital Infantil Albert Sabin, in Ceará, Northeast Brazil. Such diagnosis was based on clinical and tomographic criteria. Previous history, clinical findings at the diagnosis, complementary exams, and follow-up data were evaluated.
  
  
  RESULTS
  35 children diagnosed with bronchiolitis obliterans were identified. There was a predominance of male patients (3:1). The mean age at the onset of symptoms was 7.5 months, and bronchiolitis obliterans was diagnosed at a mean age of 21.8 months. The most common clinical findings were crackles/wheezing, tachypnea, dyspnea, and chest deformity. Post-infectious etiology was the main cause of bronchiolitis obliterans. Predominant findings at chest X-ray and high resolution computed tomography were peri-bronchial thickening and mosaic pattern, respectively. The treatment was variable and individualized. The majority of patients improved during follow-up, despite the persistence of respiratory symptoms.
  
  
  CONCLUSIONS
  In this study, the predominance of male patients and post-infectious etiology was noted, corroborating scientific literature. The most common tomographic findings were similar to those described in previous studies (mosaic pattern, peri-bronchial thickening, and bronchiectasis). Evidence about the treatment of this disease is still lacking. The diagnosis was delayed, which indicates that clinical suspicion of bronchiolitis obliterans is necessary in children with persistent and severe wheezing.
authors.affiliation: Hospital Infantil Albert Sabin, Fortaleza, CE, Brasil.
authors.forename: Carolina Arcanjo
authors.initials: CA
authors.lastname: Lino
authors.forename: Allyne Kelly M
authors.initials: AK
authors.lastname: Batista
authors.forename: Maria Aparecida D
authors.initials: MA
authors.lastname: Soares
authors.forename: Angela Elizabeth H
authors.initials: AE
authors.lastname: de Freitas
authors.forename: Larissa Calheiros
authors.initials: LC
authors.lastname: Gomes
authors.forename: José Holanda
authors.initials: JH
authors.lastname: M Filho
authors.forename: Vivianne Calheiros C
authors.initials: VC
authors.lastname: Gomes
mesh_terms: D000554:Ambulatory Care Facilities; D001989:Bronchiolitis Obliterans / Q000175:diagnosis* / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D011859:Radiography; D012017:Referral and Consultation; D012189:Retrospective Studies; D012959:Socioeconomic Factors