Experience in PIBO in our center

Abstract

Introduction: Post-infectious bronchiolitis obliterans (PIBO) is a rare chronic obstructive lung disease secondary to small airway injury-related chronic inflammation. The aim of this study is to describe clinical features, lung function test results and outcomes of 62 children with PIBO.

Methods: Sixty-two children diagnosed with PIBO at Hospital Universitari Vall d’Hebron in Barcelona (Spain) between 2010-2018 were retrospectively analysed. Their clinical characteristics, lung function test (spirometry, pletysmography, lung clearance index), treatment and outcomes were reported.

Results: Mean follow up was 9 years. 48% were males with a median age at diagnosis 1.45 years (+/- 2.2). More than a half (64.5%) were admitted with a median stay of 4 days (+/- 8). 45% required oxygen supplementation although only 14.5% needed mechanical ventilation. Regarding initial infection, patients with positive microbial identification, Adenovirus was the most common. HRCT were consistent with the PIBO diagnosis in all of the patients. Initial spirometry revealed a fixed obstructive airway dysfunction and regarding plethysmographic variables were high. Lung clearance index (LCI) was done in 17 patients with mean values of 15,47, higher from the controlls described on literature. Most patients presented a good long-term outcome; only a small percentage had a severe disease with chronic respiratory failure, needing in lung transplantation 4 patients (6%), in all explants wit found bronchitis and bronchiolitis.

Conclusions: Patients with chronic disease have good outcome in our follow up until 18 years of age.