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Chronic idiopathic bronchiolitis of infancy
J Hull1, C W Chow, C F Robertson
1Department of Thoracic Medicine, Royal Children's Hospital, Melbourne, Australia.
Archives of Disease in Childhood
|March 13, 1998
Summary
A chronic respiratory illness in infants, characterized by rapid breathing and crackles, shows improvement over time. This previously unreported condition appears to have a favorable prognosis, with most infants recovering well.
Area of Science:
- Pediatrics
- Pulmonology
- Pathology
Background:
- Eight infants presented with chronic respiratory illness within their first year of life.
- Symptoms included tachypnea and inspiratory crackles, with some requiring supplemental oxygen.
- Initial investigations for infection, cardiac disease, and reflux were negative.
Purpose of the Study:
- To describe the clinical and morphological features of a previously unreported infant respiratory illness.
- To evaluate the diagnostic findings and medium-term prognosis of affected infants.
Main Methods:
- Clinical observation and auscultation for respiratory symptoms.
- Chest radiography for imaging findings.
- Open lung biopsy for histological examination.
- Long-term follow-up of clinical outcomes and growth.
Main Results:
- Chest X-rays revealed non-specific perihilar alveolar shadowing and hyperinflation.
- Lung biopsies showed mild lymphocytic bronchiolar infiltration in most cases; two were normal.
- Steroid treatment showed no apparent benefit.
- All infants demonstrated continuous improvement, with reduced oxygen dependence and persistent but decreased crackles.
Conclusions:
- The findings suggest a previously unreported respiratory entity in infants.
- Clinical presentation and biopsy findings predict a favorable medium-term prognosis.
- Most infants experienced significant recovery and normal development.