Postinfectious bronchiolitis obliterans in children: lessons from bronchiolitis obliterans after lung transplantation and hematopoietic stem cell transplantation

Korean journal of pediatrics
Jinho Yu

Abstract

Postinfectious bronchiolitis obliterans (PIBO) is an irreversible obstructive lung disease characterized by subepithelial inflammation and fibrotic narrowing of the bronchioles after lower respiratory tract infection during childhood, especially early childhood. Although diagnosis of PIBO should be confirmed by histopathology, it is generally based on history and clinical findings. Irreversible airway obstruction is demonstrated by decreased forced expiratory volume in 1 second with an absent bronchodilator response, and by mosaic perfusion, air trapping, and/or bronchiectasis on computed tomography images. However, lung function tests using spirometry are not feasible in young children, and most cases of PIBO develop during early childhood. Further studies focused on obtaining serial measurements of lung function in infants and toddlers with a risk of bronchiolitis obliterans (BO) after lower respiratory tract infection are therefore needed. Although an optimal treatment for PIBO has not been established, corticosteroids have been used to target the inflammatory component. Other treatment modalities for BO after lung transplantation or hematopoietic stem cell transplantation have been studied in clinical trials, and the result...Continue Reading

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Citations

Aug 4, 2016·Expert Review of Respiratory Medicine·Naim KittanaAbdel-Naser Zaid
Nov 12, 2016·Cell and Tissue Research·Mark KuehnelDanny Jonigk
Feb 26, 2019·Expert Review of Respiratory Medicine·Ema Kavaliunaite, Paul Aurora
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Jul 4, 2020·Scientific Reports·Syakirin Sirol Aflah SyazatulVenerino Poletti
Dec 12, 2020·Pediatric Pulmonology·Jae Hwa JungKyung Won Kim
Jan 9, 2021·Der Pathologe·Christopher WerleinDanny Jonigk

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Methods Mentioned

BETA
bronchoalveolar lavage
biopsy

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