선행한 하기도감염 없이 발생한 폐쇄세기관지염의 임상 양상
Clinical characteristics of bronchiolitis obliterans without preceding severe lower respiratory tract infection
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Methods: Twenty patients referred for chronic respiratory symptoms and diagnosed with BO were enrolled and divided into 2 age groups: group 1 (<2 years, n=12) and group 2 (≥2, <6 years, n=8). A diagnosis of BO was made based on clinical and radiologic findings: (1) persistent cough or abnormal breath sounds which were not responsive to any treatment for more than 6 weeks; and (2) mosaic perfusion on high-resolution computed tomography. None of the subjects had experienced LRTI since birth, and those who had any underlying problems were excluded. The clinical characteristics and disease course were examined retrospectively. Results: Mean age of the patients was 6.8 months and 3.4 years in group 1 and 2, respectively. All patients presented with chronic cough and the most common type of cough was mixed (wet and dry), 67% in group 1 and 50% in group 2. Persistent stridor was the major respiratory sign in group 1 (67%), but 63% of group 2 patients showed no abnormal breath sounds. Chest x-ray finding was nonspecific in 75% each of both groups. The respiratory symptoms and signs resolved rapidly in most patients treated with pulse corticosteroid therapy. Bronchial hyperresponsiveness and decreased forced expiratory volume in 1 second were observed in 3 of group 2 children at age 6, during the follow-up. Conclusion: Our study shows that BO could develop without preceding severe LRTI. It also suggests that BO should be considered in the infants with persistent stridor accompanied by chronic cough.
Abstract
Methods: Twenty patients referred for chronic respiratory symptoms and diagnosed with BO were enrolled and divided into 2 age groups: group 1 (<2 years, n=12) and group 2 (≥2, <6 years, n=8). A diagnosis of BO was made based on clinical and radiologic findings: (1) persistent cough or abnormal breath sounds which were not responsive to any treatment for more than 6 weeks; and (2) mosaic perfusion on high-resolution computed tomography. None of the subjects had experienced LRTI since birth, and those who had any underlying problems were excluded. The clinical characteristics and disease course were examined retrospectively. Results: Mean age of the patients was 6.8 months and 3.4 years in group 1 and 2, respectively. All patients presented with chronic cough and the most common type of cough was mixed (wet and dry), 67% in group 1 and 50% in group 2. Persistent stridor was the major respiratory sign in group 1 (67%), but 63% of group 2 patients showed no abnormal breath sounds. Chest x-ray finding was nonspecific in 75% each of both groups. The respiratory symptoms and signs resolved rapidly in most patients treated with pulse corticosteroid therapy. Bronchial hyperresponsiveness and decreased forced expiratory volume in 1 second were observed in 3 of group 2 children at age 6, during the follow-up. Conclusion: Our study shows that BO could develop without preceding severe LRTI. It also suggests that BO should be considered in the infants with persistent stridor accompanied by chronic cough.
참고문헌 (29)
- Schlesinger C, "Constructive(obliterative)bronchiolitis", Curr Opin Pulm Med, 4, pp.288~293 (1998)
- Shaw RJ, "The role of small airways in lung disease", Respir Med, 96, pp.67~80 (2002)
- Kurland G, "Bronchiolitis obliterans in children", Pediatr Pulmonol, 39, pp.193~208 (2005)
- Fischer GB, "Post infectious bronchiolitis obliterans in children", Paediatr Respir Rev, 11, pp.233~239 (2010)
- Colom AJ, "Post-infectious bronchiolitis obliterans", Pediatr Pulmonol, 54, pp.212~219 (2019)
- Castro-Rodriguez JA, "Adenovirus pneumonia in infants and factors for developing bronchiolitis obliterans : a 5-year follow-up", Pediatr Pulmonol, 41, pp.947~953 (2006)
- Colom AJ, "Risk factors for the development of bronchiolitis obliterans in children with bronchiolitis", Thorax, 61, pp.503~506 (2006)
- Moonnumakal SP, "Bronchiolitis obliterans in children", Curr Opin Pediatr, 20, pp.272~278 (2008)
- Smith LJ, "Normal development of the lung and premature birth", Paediatr Respir Rev, 11, pp.135~142 (2010)
- Thorne MC, "Laryngomalacia : review and summary of current clinical practice in 2015", Paediatr Respir Rev, 17, pp.3~8 (2016)
- Barker AF, "Obliterative bronchiolitis", N Engl J Med, 370, pp.1820~1828 (2014)
- Kavaliunaite E, "Diagnosing and managing bronchiolitis obliterans in children", Expert Rev Respir Med, 13, pp.481~488 (2019)
- 최선희, "소아청소년에서 만성 기침", Allergy Asthma & Respiratory Disease, 4(4), pp.235~247 (2016), 대한 소아알레르기 호흡기학회[DOI]
- Chang AB, "Guidelines for evaluating chronic cough in pediatrics: ACCP evidence-based clinical practice guidelines", 129(1 Suppl), pp.260S~283S (2006)
- Chang AB, "Chronic wet cough : protracted bronchitis, chronic suppurative lung disease and bronchiectasis", Pediatr Pulmonol, 43, pp.519~531 (2008)
- Donnelly D, "‘Dry’ and ‘wet’ cough : how reliable is parental reporting?", BMJ Open Respir Res, 6, pp.e000375~ (2019)
- Chang AB, "Management of children with chronic wet cough and protracted bacterial bronchitis : CHEST Guideline and expert panel Report", Chest, 151, pp.884~890 (2017)
- Venkatesan NN, "Laryngopharyngeal reflux disease in children", Pediatr Clin North Am, 60, pp.865~878 (2013)
- Colom AJ, "Pulmonary function of a paediatric cohort of patients with postinfectious bronchiolitis obliterans. a long term follow-up", Thorax, 70, pp.169~174 (2015)
- Zwaans WA, "The relevance of respiratory viral infections in the exacerbations of chronic obstructive pulmonary disease—a systematic review", J Clin Virol, 61, pp.181~188 (2014)
- Williams KM, "Fluticasone, azithromycin, and montelukast treatment for new-onset bronchiolitis obliterans syndrome after hematopoietic cell transplantation", Biol Blood Marrow Transplant, 22, pp.710~716 (2016)
- Fullmer JJ, "Successful treatment of bronchiolitis obliterans in a bone marrow transplant patient with tumor necrosis factor-alpha blockade", Pediatrics, 116, pp.767~770 (2005)
- Tomikawa SO, "Follow-up on pediatric patients with bronchiolitis obliterans treated with corticosteroid pulse therapy", Orphanet J Rare Dis, 9, pp.128~ (2014)
- Tanou K, "Efficacy of pulse methylprednisolone in a pediatric case of postinfectious bronchiolitis obliterans", Pediatr Pulmonol, 50, pp.E13~E16 (2015)
- Wang X, "Clinical features of post-infectious bronchiolitis obliterans in children undergoing long-term azithromycin treatment", Exp Ther Med, 9, pp.2379~2383 (2015)
- Kerger BD, "Pathology, toxicology, and latency of irritant gases known to cause bronchiolitis obliterans disease : does diacetyl fit the pattern?", Toxicol Rep, 2, pp.1463~1472 (2015)
- Zhang L, "Clinical course of postinfectious bronchiolitis obliterans", Pediatr Pulmonol, 29, pp.341~350 (2000)
- Aguerre V, "Postinfectious bronchiolitis obliterans in children : clinical and pulmonary function findings", Pediatr Pulmonol, 45, pp.1180~1185 (2010)
- Yoo Y, "Methacholine and adenosine 5΄-monophosphate challenges in children with post-infectious bronchiolitis obliterans", Eur Respir J, 27, pp.36~41 (2006)