Multicenter Study of Bronchiolitis Obliterans in Korean Children.
- Author:
Soo Jong HONG
1
;
Bong seong KIM
;
Kang Mo AHN
;
Sang Il LEE
;
Kyu Earn KIM
;
Ki Young LEE
;
Dae Hyun LIM
;
Byong Kwan SON
Author Information
1. Department of Pediatrics, College of Medicine, University of Ulsan, Korea. sjhong@www.amc.seoul.kr
- Publication Type:Multicenter Study ; Original Article
- Keywords:
Bronchiolitis obliterans;
Adenovirus;
High resolution computed tomography;
Corticosteroid
- MeSH:
Adenoviridae;
Bronchiolitis Obliterans*;
Bronchiolitis*;
Child*;
Diagnosis;
Epidemiology;
Follow-Up Studies;
Glass;
Hospitals, University;
Humans;
Lung Diseases;
Orthomyxoviridae;
Paramyxoviridae Infections;
Retrospective Studies
- From:Pediatric Allergy and Respiratory Disease
2002;12(2):136-145
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Bronchiolitis and bronchiolitis obliterans(BO) are an inflammatory lung diseases that primarily affects the small conducting airways. There are few data regarding the epidemiology, pathophysiology, long term sequelae, and the therapy of bronchiolitis obliterans. The aim of the study is to determine the clinical profile, etiology, high resolution computed tomography(HRCT) findings and response to treatment in Korean children diagnosed with BO. METHODS: We performed a retrospective study to define the clinical course, HRCT findinding, etiologic agents, initial and follow-up symptom score(Denver), and response to intravenous corticosteroid of 34 children with BO in four university hospitals between February 1995 and February 2000. RESULTS: Median age of diagnosis of BO was 17.5 months(3 to 79 months), that of initial infectious insult was 11 months(3 to 79 months), and median duration of BO diagnosed after acute illness was 1 month(1 to 32 months). Clinical manifestations are prolonged/recurrent cough(97%), sputum(85%), respiratory difficulty(65%), wheeze(59%), fever(44%), and exertional dyspnea(18%). HRCT findings included mosaic perfusion(65%), bronchial wall thickening(62%), atelectasis(47%), hyperinflation(44%), varying degrees of bronchiectasis(35%), and ground glass opacity(25%). Thirty two cases were associated with infections and most common infectious agents was adenovirus(n=15, 44%). Other infections were influenza virus (n=3, 9%), mycoplasma(n=2, 6%), respiratory syncytial virus(n=1, 3%), and parainfluenza virus(n=1, 3%). Initial symptom scores were higher in intravenous corticosteroid treated group than untreated group, and follow-up scores were decreased in both groups. CONCLUSION: Most cases associated with infection and Adenovirus was the most common cause of BO. Corticosteroid treatment during the acute and chronic phases may improve the functional status of BO patients.
