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Non-Linear Dysanaptic Lung Growth in Patients With Post-Infectious Bronchiolitis Obliterans
James M Clegg1, Ferdinand Cacho1, Matthew D McGraw2
1Department of Pediatrics, Division of Pediatric Pulmonology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Pediatric Pulmonology
|July 3, 2026
Summary
Post-infectious bronchiolitis obliterans (PIBO) leads to abnormal lung growth in children, with stagnant FEV1. Adenovirus infection results in initially lower, but faster-growing, FVC compared to other pathogens.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Infectious Diseases
Background:
- Longitudinal pulmonary function in post-infectious bronchiolitis obliterans (PIBO) is understudied.
- This study examines pulmonary function changes over time in PIBO patients, considering the inciting pathogen.
Purpose of the Study:
- To analyze longitudinal pulmonary function outcomes in children with PIBO.
- To investigate the impact of time and specific respiratory pathogens on lung function in PIBO.
Main Methods:
- Retrospective analysis of PIBO patients at a single center.
- Serial spirometry data analyzed using generalized mixed-effects models.
- Exploratory analysis of pathogen, age at infection, and corticosteroid exposure interactions.
Main Results:
- Fifteen PIBO patients (80% male) were identified; common pathogens included adenovirus and Mycoplasma pneumoniae.
- Initial spirometry showed significantly reduced FEV1, FVC, and FEV1/FVC z-scores.
- FVC z-scores improved significantly over time (0.185/year), while FEV1/FVC ratio declined (-0.143/year).
- Adenovirus infection was associated with accelerated FVC growth compared to other pathogens.
Conclusions:
- PIBO patients exhibit non-linear, dysanaptic lung growth with stagnant FEV1.
- Adenovirus-infected children showed initially lower FVC but accelerated growth.
- Further research is needed on severe respiratory infections and dysanaptic lung growth in children.
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