Diagnosing and managing bronchiolitis obliterans in children

Expert Review of Respiratory Medicine
Ema Kavaliunaite, Paul Aurora

Abstract

Bronchiolitis obliterans (BO) is a chronic and irreversible obstructive lung disease leading to the obstruction and/or obliteration of the small airways. Three main BO entities are distinguished: post-infectious BO (PIBO); BO post lung transplantation; and BO after bone marrow transplantation (BMT) or hematopoietic stem cell transplantation (HSCT). All three entities are separate, however, there are similarities in histopathological characteristics and possibly in aspects of the development pathway. Areas covered: We review current evidence of bronchiolitis obliterans diagnosis and management in children. The diagnosis of BO is usually based on a combination of history, clinical and radiological findings, although lung biopsy and histopathology remain the gold standard approaches to confirm BO. Expert opinion: At present, we do not have a clear understanding of the mechanisms of the development of BO and lack strong evidence for treatment. Although most BO in children is post-infectious, most of the current evidence for treatment originates from studies analyzing BO in adult lung transplant and HSCT patients. BO management requires multidisciplinary approach and care in specialized centers.

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Citations

Jun 10, 2020·Pediatric Pulmonology·Emine AtagBulent Karadag
Jul 7, 2020·International Journal of Molecular Medicine·Ioannis N MammasDemetrios A Spandidos
Feb 23, 2020·Canadian Respiratory Journal : Journal of the Canadian Thoracic Society·Silvija-Pera JerkicMartin Rosewich
Nov 12, 2020·Pediatric Pulmonology·Kate C ChanAlbert M Li
Dec 3, 2020·Frontiers in Pediatrics·Emine AtagRefika Ersu
May 23, 2021·The Journal of Pediatrics·Lauren M CarpenterDeborah R Liptzin
Jun 8, 2021·Heart & Lung : the Journal of Critical Care·Hakan YazanErkan Cakir
Jul 20, 2021·Curēus·Ninoshka M Caballero-ColónWilfredo De Jesús-Rojas
Dec 30, 2021·Pediatric Pulmonology·Timothy J VeceWilliam A Gower

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