TY - JOUR T1 - Obliterative bronchitis verified by bronchoscopic visualisation JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p4569 AU - Petr Pohunek AU - Karolina Vávrová AU - Tamara Svobodová AU - Magdalena Havlišová AU - Ludmila Hornofová Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p4569.abstract N2 - Background: Chronic bronchial obstruction in children is mostly associated with bronchial asthma. In those with irreversible obstruction the most documented reason is a post-infectious obliterative bronchiolitis.Case history: We report a 13 years old patient with Tetralogy of Fallot corrected at the age of 3 years. She suffered from respiratory infections since early childhood, in addition four pneumonias at the age of 10, 11 and 12 years. Since age of 10 on anti-asthma medication for frequent wheezing. She was referred to us for poor response to anti-asthma therapy.Summary of findings: No dyspnoea, bilateral variable quiet wheezing. FVC 53%,FEV1 34%,MEF 25/75 12%. TLC normal, severe hyperinflation. No immune deffect, no atopy. GOR excluded. On HRCT diffuse bilateral non-homogeneous air-trapping. On bronchoscopy normal anatomy, non-inflammatory mucosa. Bronchial biopsy with no inflammation, no remodelling.Using 2.9 mm flexible bronchoscope and aiming for the areas with prominent air-trapping, we found at the level of 7th to 9th bronchial branching circular narrow stenoses and obliterative lesions completely closing the lumen. Biopsy revealed normal bronchial epithelium, mild thickening of the basement membrane and mild hypertrophy of smooth muscle.Conclusion: We confirmed existence of obliterative lesions causing irreversible obstruction in the bronchi of about 2 to 3 mm in diameter. This fits into the diagnosis of obliterative bronchitis, different from obliterative bronchiolitis. This should be suspected in children with irreversible bronchial obstruction and appropriate investigations initiated. Confirmation of this diagnosis can prevent patients from unnecessary burden of anti-asthma therapy.Supported by MZ0FNM2005. ER -