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The obstacle race of post-infectious bronchiolitis obliterans (PIBO): Prognostic factor analysis

Cátia Pereira, Carolina Constant, Ana Margarida Silva, Teresa Bandeira
European Respiratory Journal 2016 48: PA1603; DOI: 10.1183/13993003.congress-2016.PA1603
Cátia Pereira
1Respiratory Unit, Department of Pediatrics, Hospital Santa Maria (CHLN), Lisbon, Portugal
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Carolina Constant
1Respiratory Unit, Department of Pediatrics, Hospital Santa Maria (CHLN), Lisbon, Portugal
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Ana Margarida Silva
1Respiratory Unit, Department of Pediatrics, Hospital Santa Maria (CHLN), Lisbon, Portugal
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Teresa Bandeira
1Respiratory Unit, Department of Pediatrics, Hospital Santa Maria (CHLN), Lisbon, Portugal
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Abstract

Evidence about disease progression in PIBO is scarce. Although it seems to stabilize over time there are no clear markers of outcome.

Aims: To ascertain if clinical and lung function(LF) indices qualify stability in PIBO.

Methods: Retrospective chart review of the medical records of 45 children with PIBO on follow-up at a tertiary hospital. Twenty-eight (62,2%) patients with at least 8 years of follow-up were included (diagnosis based on history, chest HRCT and fixed airway obstruction). Clinical stability was assumed if ≤2 exacerbations/year; LF stability if ≤5% variation in %PredFEV1 (ATS/ERS, GLI2012)between yearly tests, all for 2 consecutive years. Descriptive analysis SPSS®.

Results: Twenty(71%) patients were boys, initial injury occurred at median age of 11(0,6-68) months, 9(32%) needed mechanical ventilation. Adenovirus was the most common etiologic agent(10; 36%). Sixteen(57%) patients were atopic (positive skin prick tests/IgE). Median time of follow-up was 17,4(8,3-23,0)y; 4 had long-term home oxygen. Clinically, all patients stabilized at a median of 4,2(0,7-12,1)y after initial lung injury, yet only 9(32%) had no lung exacerbations for 2 years, which occurred at 8,0(3,1-17,4)y after initial injury. LF never stabilized by study criteria, but in 7(35%) it improved over time and in 50% varied ≤10% in %PredFEV1 from start to end of follow-up.

Conclusion: Number of exacerbations/year showed to be a more sensible marker to define stability in PIBO. Assuming 10% variation in %PredFEV1 is probably wiser due to the propensity of PIBO/asthma overlap syndrome. Increasing sample size and analyzing trends in LF may inform about PIBO's prognosis and help design specific interventions.

  • COPD - mechanism
  • Spirometry
  • Children
  • Copyright ©the authors 2016
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The obstacle race of post-infectious bronchiolitis obliterans (PIBO): Prognostic factor analysis
Cátia Pereira, Carolina Constant, Ana Margarida Silva, Teresa Bandeira
European Respiratory Journal Sep 2016, 48 (suppl 60) PA1603; DOI: 10.1183/13993003.congress-2016.PA1603

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The obstacle race of post-infectious bronchiolitis obliterans (PIBO): Prognostic factor analysis
Cátia Pereira, Carolina Constant, Ana Margarida Silva, Teresa Bandeira
European Respiratory Journal Sep 2016, 48 (suppl 60) PA1603; DOI: 10.1183/13993003.congress-2016.PA1603
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