Post- infectious bronchiolitis obliterans in children: clinical and
radiological evaluation and lon- term results
Abstract Objective: This study aims to evaluate clinical and
radiological findings and treatment outcomes of the patients with PIBO.
Methods: One hundred fourteen children were enrolled. Initial
demographic and clinical findings were evaluated. Pre- and
post-treatment symptoms, radiological findings and scores, the number of
admissions to the hospital and PICU were compared. Results:
Seventy-three patients were male. The median age of the patients at
initial pulmonary injury was 7.2 months, the median age at diagnosis was
17.5 months and the median interval from initial injury to diagnosis was
8.5 months. Thirty-five patients had mechanical ventilation history.
Persistent wheezing was the most common complaints. The most common
radiological findings were peribronchial thickening and air-trapping.
Sixty-eight patients were treated with inhaled corticosteroid (IC),
systemic corticosteroid (SC) and azithromycin (AZT) combination. 25
patients were treated with only IC, 14 with IC and AZT, and 7 with IC
and SC. 82,5% of patients had clinical improvement. Chronic respiratory
failure occurred in 11 patients, and three patients died.
Bronchiectasis, atelectasis, hyperinflation and air trapping in HRCT
improved significantly. Bhalla scores decreased from 8.3 to 6.5 (p=
0,001). IC, SC and AZT combination was effective than the other
treatments. Conclusions: This study is one of the largest studies in the
literature and one of the few studies that evaluate clinical and
radiological outcomes. We found that IC, AZT and SC combination is
clinically and radiologically effective in patients with PIBO.