bronchoscopy findings in children with asthma symptoms
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Bronchoscopy Findings in Children with Asthma Symptoms. Özge Pamukçu, Z.S. Uyan, E. Çakır, S. Öktem, F. Karakoç, B. Karadağ, R. Ersu, E. Dağlı Marmara University Medical Faculty, Dep. of Pediatric Pulmonology,İSTANBUL. Introduction. - PowerPoint PPT PresentationTRANSCRIPT
Bronchoscopy Findings in Children with Asthma
SymptomsÖzge Pamukçu,
Z.S. Uyan, E. Çakır, S. Öktem, F. Karakoç, B. Karadağ, R. Ersu, E. Dağlı
Marmara University Medical Faculty, Dep. of Pediatric
Pulmonology,İSTANBUL
IntroductionPersistent or recurrent wheezing in infancy is a common
symptom.
Prevalance of wheezing in infancy varies from 4 to 32%
In wheezy children flexible bronchoscopy is indicated to
evaluate associated anatomic and/or functional
abnormalities.
Flexible bronchoscopy is an important diagnostic tool in the
differential diagnosis of wheezing and treatment plan of
asthma.
Introduction
Patients who respond poorly to corticosteroids, particularly
those in whom unconventional therapies are being
considered, should undergo bronchoscopy.
This allows direct inspection of the airways and gives an
opportunity for examination of the underlying pathology.
29 of the 34 patients with persistent and/or recurrentwheezing whose symptoms recurred or did not improvedespite bronchodilator and steroid treatment hadfunctional and/or structural respiratory tract anomalies. Aslan Allergy and Asthma Nov 2005
A retrospective case series was reported in whichbronchoscopy was used to investigate 30 young childrenwith recurrent wheezing who had been poorly responsive tobronchodilators. Although they had been tentatively labeledas asthmatic patients, tracheomalacia was found in almostone-half of the cases. Schellhase J. Pediatrics 1998
In a recent study of 885 bronchoscopic procedures, 299
cases of malacia disorders (34%) were observed.
Masters Pediatric Pulmonology 2002
In another study of 17 patients with onset of wheezing
earlier than 6 months of age and a diagnosis of
hyperreactive airway disease, bronchomalacia was
detected in flexible bronchoscopy. Finder J. Pediatrics 1997
No complications had been observed after bronchoscopy of
36 asthmatic subjects. Humbert, Thorax BMJ
1996
Flexible bronchoscopy was performed to 48 children with
Difficult asthma and 35 nonasthmatic children. The total
number of perioperative complications was greater in the
non-asthmatics undergoing flexible bronchoscopy than in
the asthmatics. Payne, Arch Dis Child 2001
Aim
To investigate the efficacy and the safety of bronchoscopy
in children with persistent or recurrent wheezing.
Method
We retrospectively reviewed the bronchoscopy results of
112 patients that have been followed for persistent or
recurrent wheezing in our clinic.
Results
Demographic characteristics of patients
Sex Age
(median)
Duration of symptoms
(median)
Male: 62 % 13.5 months
(IQR: 7- 44)
5 months
(IQR: 2- 14)
Results
The diagnosis of 40 % of the patients was changed after
bronchoscopy; bronchoscopy results of 30 % of patients
were normal
Laryngotracheomalacia
Foreign BodyAspiration
External Compression
Anatomic Variation
Secretion
Normal
Bronchoscopy Results
Results
33.5% 26,5%
12.4%2.7% 11.5%
12.4%
Results
Hypoxia
Transient tachycardia
Stridor
No complication
92,6%
0,9%
0,9%5,6%
None of the patients had major complications
Conclusion
Flexible bronchoscopy has an important role in the
differential diagnosis of young patients who have asthma
symptoms and it is a safe procedure without any major
complications.