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Post-infectious bronchiolitis obliterans in children: CT features that predict responsiveness to pulse

H M Yoon1, J S Lee, J-Y Hwang

  • 11 Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

The British Journal of Radiology
|February 25, 2015
PubMed

Insights

Intravenous pulse methylprednisolone therapy (IPMT) can improve air trapping in children with post-infectious obliterative bronchiolitis (OB). Pre-treatment CT showing thickened bronchial walls may predict a positive response to IPMT in these patients.

Area of Science:

  • Pediatric Pulmonology
  • Radiology
  • Pharmacology

Background:

  • Post-infectious obliterative bronchiolitis (OB) is a serious condition in children.
  • Intravenous pulse methylprednisolone therapy (IPMT) is a treatment option for OB, but its effectiveness varies.
  • Predicting response to IPMT is crucial for optimal patient management.

Purpose of the Study:

  • To evaluate if CT and clinical features can predict responsiveness to IPMT in children with post-infectious OB.
  • To identify predictors of successful IPMT in pediatric OB patients.
  • To correlate pre-treatment imaging findings with treatment outcomes.

Main Methods:

  • Retrospective review of 17 children with post-infectious OB treated with IPMT.
  • Analysis of pre- and post-treatment chest CT scans to assess air trapping.
  • Comparison of radiological features and clinical data between responders and non-responders.

Main Results:

  • Thickened bronchial walls on pre-treatment CT were significantly associated with a positive response to IPMT (p=0.029).
  • Responders were significantly younger (median 2.0 vs 7.5 years) and had a shorter interval from initial pneumonia to IPMT (median 4 vs 50 months).
  • No significant differences were found in bronchiolitis, bronchiectasis, or extent of air trapping between groups.

Conclusions:

  • Pre-treatment CT findings, specifically bronchial-wall thickening, can predict favorable response to IPMT in children with post-infectious OB.
  • Early IPMT may be more effective in younger children with a shorter disease duration.
  • IPMT can improve air trapping in selected pediatric OB patients.
Abstract

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