Bronchiolitis obliterans in children: clinical profile and diagnosis

Respirology. 2000 Dec;5(4):369-75.

Abstract

Objective: The aim of the study was to determine the clinical profile, aetiology and radiological categories in children diagnosed with bronchiolitis obliterans (BO).

Methodology: We undertook a review of the medical records and radiological studies of 14 children with BO.

Results: Unresolving cough and wheeze after a short respiratory illness was the commonest presentation. A viral pneumonitis was identified as the initial respiratory event prior to the development of BO in six children and Mycoplasma pneumoniae was the cause in another three children. Chest X-ray findings could be divided into four distinct patterns that were hyperinflation (n=5), mixed pattern of atelectasis, hyperlucency and bronchial thickening (n=4), unilateral small hyperlucent lung (n=3) and unilateral collapse of one lung (n=2). High resolution computed tomogram (HRCT) chest showing areas of hyperaeration and mosaic ground glass patterns with bronchial thickening were commonly found in patients whose chest X-ray showed bilateral changes. Patients with bilateral lung changes were more likely to have failure to thrive and persistent respiratory symptoms on follow up.

Conclusion: A diagnosis of BO can be made from typical clinical features combined with an understanding of the different chest X-ray categories and HRCT of the chest. A viral aetiology was the commonest cause for BO in our series.

MeSH terms

  • Adolescent
  • Bronchiolitis Obliterans / diagnostic imaging*
  • Bronchiolitis Obliterans / etiology*
  • Child
  • Child, Preschool
  • Cough / etiology
  • Failure to Thrive / etiology
  • Female
  • Hospitalization
  • Humans
  • Infant
  • Malaysia
  • Male
  • Pneumonia / complications
  • Pneumonia / microbiology
  • Respiratory Sounds / etiology
  • Retrospective Studies
  • Tomography, X-Ray Computed