Deng Li-Xin, Chen De-Hui, Lin Yu-Neng, Wu Shang-Zhi, Xu Jia-Xing, Huang Zhan-Hang, Gu Ying-Ying, Feng Jun-Xiang
Department of Pediatrics, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou 510120, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2025 Mar 15;27(3):334-339. doi: 10.7499/j.issn.1008-8830.2409125.
To analyze the clinical characteristics of diffuse panbronchiolitis (DPB) in children and to enhance the clinical diagnosis and treatment of this disease.
A retrospective analysis was conducted on the clinical data of 6 children diagnosed with DPB who were hospitalized at The First Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2019.
Among the 6 patients, there were 2 males and 4 females; the age at diagnosis ranged from 7 to 12 years. All patients presented with cough, sputum production, and exertional dyspnea, and all had a history of sinusitis. Two cases showed positive serum cold agglutinin tests, and 5 cases exhibited pathological changes consistent with chronic bronchiolitis. High-resolution chest CT in all patients revealed centrilobular nodules diffusely distributed throughout both lungs with a tree-in-bud appearance. Five patients received low-dose azithromycin maintenance therapy, but 3 showed inadequate treatment response. After empirical anti-tuberculosis treatment, non-tuberculous were found in the bronchoalveolar lavage fluid. Follow-up over 2 years showed 1 case cured, 3 cases significantly improved, and 2 cases partially improved.
The clinical presentation of DPB is non-specific and can easily lead to misdiagnosis. In cases where DPB is clinically diagnosed but does not show improvement with low-dose azithromycin treatment, special infections should be considered.
分析儿童弥漫性泛细支气管炎（DPB）的临床特征，提高该病的临床诊断与治疗水平。
对2011年1月至2019年12月在广州医科大学附属第一医院住院确诊为DPB的6例患儿的临床资料进行回顾性分析。
6例患者中，男性2例，女性4例；确诊年龄7～12岁。所有患者均有咳嗽、咳痰及活动后气促，均有鼻窦炎病史。2例血清冷凝集试验阳性，5例病理改变符合慢性细支气管炎。所有患者高分辨率胸部CT均显示两肺弥漫性分布的小叶中心结节，呈树芽征。5例患者接受低剂量阿奇霉素维持治疗，但3例治疗反应欠佳。经经验性抗结核治疗后，支气管肺泡灌洗液中未发现结核分枝杆菌。随访2年，1例治愈，3例明显好转，2例部分好转。
DPB临床表现无特异性，易导致误诊。临床诊断为DPB但低剂量阿奇霉素治疗效果不佳时，应考虑特殊感染。
