RT Journal Article
SR Electronic
T1 Is there a delay in diagnosis of post infectious obliterative bronchiolitis (PBO)?
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4123
VO 40
IS Suppl 56
A1 Sonal Kansra
A1 Harish Vyas
A1 Alan Smyth
A1 John Somers
A1 Jayesh Bhatt
YR 2012
UL http://erj.ersjournals.com/content/40/Suppl_56/P4123.abstract
AB Background: PBO, an orphan lung disease results following an antecedent severe viral lower respiratory tract infection (LRTI),commonly due to adenovirus.The clinical symptoms of PBO are non-specific.This may result in a significant delay in diagnosis.Methods: We retrospectively examined the medical records of children with PBO to determine the time from initial illness to diagnosis based on clinical and radiological criteria as follows:1. History of antecedent viral LRTI2. Evidence of airway obstruction (clinical or spirometry)3. Radiological investigations consistent with PBOResults: Of the nine cases identified over last 17 years,adenovirus(n=7)was the main organism implicated in the initial infection in keeping with description in literature.Common referrals were for difficult or severe wheeze, exercise limitation, recurrent respiratory infections or bronchiectasis.The diagnosis was made earlier in children who had a persistent oxygen requirement or were admitted under the care of respiratory paediatricians.View this table:Age at initial illness and at diagnosisConclusions: There is a significant delay in diagnosis of PBO in our experience. Severe LRTI especially with adenovirus and a prolonged oxygen requirement at initial presentation followed by persistent respiratory symptoms should prompt further investigations.Confirmation of the diagnosis leads to better understanding of the disease for the child with the opportunity to network with other children with rare diseases, could lead to potentially disease modifying treatment like Azithromycin and avoid unnecessary treatment for asthma.