Bronchiolitis obliterans in children: clinical profile and diagnosis.

OBJECTIVE

The aim of the study was to determine the clinical profile, aetiology and radiological categories in children diagnosed with bronchiolitis obliterans (BO).

METHODOLOGY

We undertook a review of the medical records and radiological studies of 14 children with BO.

RESULTS

Unresolving cough and wheeze after a short respiratory illness was the commonest presentation. A viral pneumonitis was identified as the initial respiratory event prior to the development of BO in six children and Mycoplasma pneumoniae was the cause in another three children. Chest X-ray findings could be divided into four distinct patterns that were hyperinflation (n=5), mixed pattern of atelectasis, hyperlucency and bronchial thickening (n=4), unilateral small hyperlucent lung (n=3) and unilateral collapse of one lung (n=2). High resolution computed tomogram (HRCT) chest showing areas of hyperaeration and mosaic ground glass patterns with bronchial thickening were commonly found in patients whose chest X-ray showed bilateral changes. Patients with bilateral lung changes were more likely to have failure to thrive and persistent respiratory symptoms on follow up.

CONCLUSION

A diagnosis of BO can be made from typical clinical features combined with an understanding of the different chest X-ray categories and HRCT of the chest. A viral aetiology was the commonest cause for BO in our series.