Efficacy of Intravenous Methylprednisolone Pulses in Children With Postinfectious Bronchiolitis Obliterans

Abstract

Objective: To assess the efficacy of intravenous methylprednisolone pulses in children with postinfectious bronchiolitis obliterans (PIBO).

Study design/methods: This French monocentric retrospective study included 31 patients with PIBO. Respiratory symptoms, occurrence of exacerbations and hospitalizations up to 4 years, and the results of lung function tests were compared between patients who received methylprednisolone pulses (n = 6) and those who did not (n = 25). A similar analysis was performed in the subgroup of the severest patients at diagnosis (five and six patients per group respectively).

Results: During their inaugural episode, patients in the treatment group were hospitalized longer (p = 0.005), more frequently in ICU (p = 0.013) and had longer oxygen needs than in the control group (p = 0.005). During their course, more patients in the treatment group required at least one nonscheduled hospitalization at 6 months of evolution than in the control group (p = 0.04). Regarding lung function tests, no significant difference was observed between the control and treatments groups. Comparing the severest patients at diagnosis in each group showed no significant difference in clinical nor functional evolution.

Conclusion: In a retrospective monocentric cohort, intravenous methylprednisolone pulses were used in severe cases of PIBO. This treatment had no effect of the subsequent evolution of these patients as compared to not treated patients.

Keywords: children; chronic obstructive lung disease; steroids.