Постинфекционный облитерирующий бронхиолит у детей: ретроспективный анализ 26 случаев заболевания

Post-infectious obliterative bronchiolitis in children: a retrospective analysis of 26 cases

Post-infectious obliterative bronchiolitis (PIOB) is an interstitial lung disease (ILD) that develops after a severe lower respiratory tract infection. Objective. To analyze the causes of development and clinical course of PIOB in children. Patients and methods. A retrospective cohort study was conducted on 26 patients (mean age 24 [9; 30] months) diagnosed with PIOB. The etiology of the disease was established in 16 children. An analysis of clinical symptoms was performed, including using the ILD severity scale developed by L.L. Fan et al., the results of computed tomography (CT) of the chest cavity organs (CCO), spirometry, and therapy. Results. The most common causes of PIOB were respiratory syncytial virus (RSV) (15%), measles virus (15%), and Bordetella pertussis (12%). Symptoms included tachypnea (92%), cough (88%), and decreased exercise tolerance (85%). CT scans revealed heterogeneous ventilation in 92% of cases. Spirometry in 15 children over 6 years of age revealed obstructive changes – median zFEV1-2.14 [-2.72;-1.71], zFEV1-0.94 [-1.52;-0.60], zFEV1/FVC-1.18 [-1.54;-0.83]. Severe PIOD (III–V stage according to the classification of severity of ILD) was more often accompanied by the need for artificial lung ventilation (77% vs. 15%, p = 0.005), hospitalization in the intensive care unit (77% vs. 31%, p = 0.047) at the onset of the disease, and the need for long-term oxygen therapy after discharge (85% vs. 23%, p = 0.005). All patients received inhaled glucocorticosteroids (GCS), 58% received azithromycin, and 31% received systemic GCS. Clinical remission was recorded in 42% of patients. Conclusion. The combination of clinical and anamnestic data and instrumental data (disease criteria) allows for the timely diagnosis of PIOB and assessment of its severity. Immunoprophylaxis of acute RSV bronchiolitis, measles, and whooping cough prevents this adverse outcome. © 2025, Dynasty Publishing House. All rights reserved.