Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Plastic bronchitis in children: 2 cases

소아 증식성 기관지염 2례

  • Kim, Yeo Hyang (Department of Pediatrics, School of Medicine, Keimyung University) ;
  • Choi, Hee Jung (Department of Pediatrics, Kumi-Cha Hospital) ;
  • Kim, Jung Ok (Division of Pediatric Cardiology, Department of Pediatric, Severance Cadiovascular Hospital Yonsei University College of Medicine) ;
  • Hyun, Myung Chul (Departments of Pediatrics, School of Medicine, Kyungpook National University)
  • 김여향 (계명대학교 의과대학 소아과학교실) ;
  • 최희정 (구미차병원 소아과청소년과) ;
  • 김정옥 (연세대학교 의과대학 심장혈관병원 소아심장과) ;
  • 현명철 (경북대학교 의과대학 소아과학교실)
  • Received : 2008.10.22
  • Accepted : 2009.06.11
  • Published : 2009.07.15
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Abstract

Plastic bronchitis is a rare disorder characterized by the formation of extensive, obstructing endobronchial casts. It is associated with asthma and complex cardiac defects such as those requiring the Fontan procedure. The treatment of plastic bronchitis comprises conventional therapy involving spontaneous expectoration and bronchoscopic removal and specific therapy with several new drugs. Herein, we describe the cases of 2 patients diagnosed with plastic bronchitis accompanied with a different underlying disease, which were treated with inhaled corticosteroid and low-dose oral clarithromycin.

증식성 기관지염(plastic bronchitis)는 기관지 내부에 폐쇄성 원주(cast)를 만드는 드문 질환으로 천식이나 선천성 심장병의 폰탄 수술 후 합병증으로 생길 수 있다. 증식성 기관지염의 치료는 원주를 스스로 뱉거나 기관지경으로 제거해주는 고식적인 치료와 새로 개발된 약제를 사용하는 단기 및 장기 치료로 나눌 수 있다. 저자들은 기저 질환이 없이 갑작스런 호흡 부전과 왼쪽 폐 전체의 무기폐를 보인 8세 남아와 폰탄 수술 병력이 있고 반복되는 오른쪽 중엽과 하엽의 무기폐를 보인 5세 여아에서 기관지 내시경을 통해 기관지내 원주를 확인하였고, 조직학적 검사에서 호산구, 호중구, 임파구와 같은 염증 세포를 포함한 점액질과 섬유질로 구성되어 있어 증식성 기관지염으로 진단후 재발 방지를 위해 흡입용 스테로이드와 저용량 경구용 clarithromycin을 사용한 경험을 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Madsen P, Shah SA, Rubin BK. Plastic bronchitis: new insights and a classification scheme. Paediatr Respir Rev 2005; 6:292-300 https://doi.org/10.1016/j.prrv.2005.09.001
  2. Kim CH, Kim SJ, Kim YK, Lee YJ, Kim KE, Lee KY. A. case of bronchial cast. Pediatr Allergy Respir Dis (Korea) 1996;6:172-6 https://doi.org/10.1007/BF01395716
  3. Kim YS, You JH, Rhee KS, Rha KS. A Case of Bronchial Cast. Korean J Pediatr 1988;31:1232-6 https://doi.org/10.1007/BF01395716
  4. Goo HW, Jhang WK, Kim YH, Ko JK, Park IS, Park JJ, et al. CT findings of plastic bronchitis in children after a Fontan operation. Pediatr Radiol 2008;38:989-93 https://doi.org/10.1007/s00247-008-0937-3
  5. Eberlein MH, Drummond MB, Haponik EF. Plastic bronchitis: a management challenge. Am J Med Sci 2008;335:163-9 https://doi.org/10.1097/MAJ.0b013e318068b60e
  6. Seear M, Hui H, Magee F, Bohn D, Cutz E. Bronchial casts in children: a proposed classification based on nine cases and a review of the literature. Am J Respir Crit Care Med 1997; 155:364-70 https://doi.org/10.1164/ajrccm.155.1.9001337
  7. Schultz KD, Oermann CM. Treatment of cast bronchitis with low-dose oral azithromycin. Pediatr Pulmonol 2003;35:135-43 https://doi.org/10.1002/ppul.10196
  8. Nayar S, Parmar R, Kulkarni S, Cherian KM. Treatment of Plastic Bronchitis. Ann Thorac Surg 2007;83:1884-6 https://doi.org/10.1016/j.athoracsur.2006.12.027
  9. Onoue Y, Adachi Y, Ichida F, Miyawaki T. Effective use of corticosteroid in a child with life-threatening plastic bronchitis after Fontan operation. Pediatr Int 2003;45:107-9 https://doi.org/10.1046/j.1442-200X.2003.01659.x
  10. Wang G, Wang YJ, Luo FM, Wang L, Jiang LL, Wang L, et al. Effective use of corticosteroids in treatment of plastic bronchitis with hemoptysis in Chinese adults. Acta Pharmacologica Sinica 2006;27:1206-12 https://doi.org/10.1111/j.1745-7254.2006.00418.x
  11. Shinkai M, Rubin BK. Macrolides and airway inflammation in children. Paediatr Respir Rev 2005;6:227-35 https://doi.org/10.1016/j.prrv.2005.06.005
  12. Keicho N, Kudoh S. Diffuse panbronchiolitis: role of macrolides in therapy. Am J Respir Med 2002;1:119-31 https://doi.org/10.1007/BF03256601
  13. Wolter J, Seeney S, Bell S, Bowler S, Masel P, McCormack J. Effect of long term treatment with azithromycin on disease parameters in cystic fibrosis: a randomized trial. Thorax 2002;57:212-6

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