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[Clinical and functional sequelae of bronchiolitis]
Insights
This study followed children with early-life bronchiolitis to age seven, finding persistent small airway obstruction and significant exercise-induced bronchial hyperreactivity in many. Allergens were detected but not strongly correlated with outcomes.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
Context:
- Bronchiolitis is a common viral infection in infants.
- Long-term respiratory sequelae are a concern.
- Assessing pulmonary function and reactivity is crucial for understanding outcomes.
Purpose:
- To evaluate the long-term clinical status and pulmonary function in children previously affected by acute bronchiolitis.
- To assess the prevalence of small airway obstruction and bronchial hyperreactivity at seven years of age.
- To investigate potential correlations with allergen sensitization and genetic predisposition.
Summary:
- Follow-up of 25 children at age seven revealed resting pulmonary function abnormalities indicative of small airway obstruction.
- A bronchial provocation test with exercise identified significant bronchial hyperreactivity in 60% of the children.
- Allergen sensitization (43% of 14 tested) was observed but showed no clear correlation with genetic factors, clinical outcomes, or bronchial hyperreactivity.
Impact:
- Highlights the potential for persistent pulmonary issues after early-life bronchiolitis.
- Emphasizes the utility of exercise challenge tests in identifying exercise-induced bronchial hyperreactivity.
- Suggests that while allergen sensitization is common, its direct link to post-bronchiolitis respiratory problems requires further investigation.
Abstract:
The authors carried out a follow-up on twenty-five children, affected with bronchiolitis in the early years of life, at seven years of age, in order to evaluate their clinical status and pulmonary function. Their parents were questioned about diseases of the small airways following to acute bronchiolitis. PRIST and RAST were effected in fourteen children; an evaluation of the pulmonary function with spirometry, flow-volume curve and body-plethysmography was done in every child. Then the flow-volume curve was repeated after bronchial provocation test with exercise (free running). Abnormalities of the pulmonary function at resting significant for small airways' obstruction were observed. A great number of children with bronchial hyperreactivity (60%) was observed after bronchial provocation test with exercise, particularly in those with genetic predisposition; 6/14 (43%) showed sensitization to many inhalant allergens, without correlation with genetic predisposition, clinical sequences and bronchial hyperreactivity.