Artigo Original / Original Article
Bronquiolite obliterante pós-infecciosa na criança
Pos-infectious bronchiolitis obliterans in children
1 Assistente Eventual de Pediatria – Serviço de Pediatria, Hospital Padre Américo / Future Paediatrics Consultant – Paediatric Unit, Hospital Padre Américo
2 Assistente Eventual de Pediatria – Departamento de Pediatria, Hospital de S. João / Future Paediatrics Consultant – Paediatric Unit, Hospital de S. João
3 Assistente Hospitalar Graduada – Departamento de Pediatria, Hospital de S. João / Specialist Consultant – Paediatric Unit, Hospital de S. João
4 Professora Auxiliar de Pediatria – Faculdade de Medicina do Porto / Assistant Professor, Paediatrics – Faculdade de Medicina do Porto
5 Chefe de Serviço – Departamento de Pediatria, Hospital de S. João / Head, Paediatric Unit, Hospital de S. João
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João / Future Paediatrics Consultant – Paediatric Unit, Hospital de S. João" "etiqueta" => "2" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Assistente Hospitalar Graduada – Departamento de Pediatria, Hospital de S. João / Specialist Consultant – Paediatric Unit, Hospital de S. João" "etiqueta" => "3" "identificador" => "af0015" ] 3 => array:3 [ "entidad" => "Professora Auxiliar de Pediatria – Faculdade de Medicina do Porto / Assistant Professor, Paediatrics – Faculdade de Medicina do Porto" "etiqueta" => "4" "identificador" => "af0020" ] 4 => array:3 [ "entidad" => "Chefe de Serviço – Departamento de Pediatria, Hospital de S. João / Head, Paediatric Unit, Hospital de S. João" "etiqueta" => "5" "identificador" => "af0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "*" "correspondencia" => "Correspondência/Correspondence to: Ana Luísa Machado Moreira Lobo, Hospital Padre Américo-Vale do Sousa, Lugar do Tapadinho 4560-162 Guilhufe Penafiel, Telefone: 255-714000 E-mail: analoboasapo.pt." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pos-infectious bronchiolitis obliterans in children" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-01-03" "fechaAceptado" => "2007-02-05" "PalabrasClave" => array:2 [ "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec570335" "palabras" => array:6 [ 0 => "Bronquiolite obliterante" 1 => "adenovírus" 2 => "etiologia" 3 => "diagnóstico" 4 => "evolução" 5 => "criança" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key-words" "identificador" => "xpalclavsec570336" "palabras" => array:6 [ 0 => "Bronchiolitis obliterans" 1 => "adenovirus" 2 => "aetiology" 3 => "diagnosis" 4 => "evolution" 5 => "children" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Na criança imunocompetente, a bronquiolite obliterante (BO) é uma doença rara que geralmente ocorre após uma infecção vírica das vias aéreas inferiores. O diagnóstico de BO era, tradicionalmente, confirmado por biópsia pulmonar. Contudo, a identificação de lesão pulmonar prévia, aliada à evolução clínica típica, radio-grafia e tomografia computorizada sugestivas, substi-tuíram a necessidade de procedimentos mais invasivos.</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">Os autores fizeram uma revisão dos processos clínicos das crianças, com o diagnóstico de BO (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>10) em seguimento numa consulta externa de pneumo-logia pediátrica, entre Janeiro de 1997 e Dezembro de 2002, com o objectivo de determinar etiologia, apresentação clínica, alterações imagiológicas, tratamento e evolução mais frequentes.</p><p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">Todas as crianças com o diagnóstico de BO apresen-tavam tosse e/ou pieira persistentes após o episódio agudo inicial. Na altura, 80% das crianças tinham má evolução ponderal. A idade média de diagnóstico foi de 16 meses. O evento inicial foi uma pneumonia e, em 9 casos, identificou-se o agente causal (cinco adenovírus, três vírus sincicial respiratório, um <span class="elsevierStyleItalic">parain</span>-<span class="elsevierStyleItalic">fluenzae</span> e um desconhecido). Na nossa casuística, ne-nhuma das crianças efectuou biópsia pulmonar, por a apresentação clínica e radiológica ser típica de BO.</p><p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">O seguimento, de 36 meses em média, revelou resolução clínica em 3 crianças e sintomas persistentes em 6. Uma criança morreu por falência respiratória progressiva.</p><p id="sp0025" class="elsevierStyleSimplePara elsevierViewall">O reconhecimento rápido do diagnóstico e o tratamento de suporte, que inclui oxigenioterapia e plano nutricional agressivo, contribuíram para melhorar o estado clínico destas crianças.</p><p id="sp0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007; XIII (4): 495-509</span></p></span>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="as0010" class="elsevierStyleSection elsevierViewall"><p id="sp0035" class="elsevierStyleSimplePara elsevierViewall">Bronchiolitis obliterans (BO) is a rare disease in immunocompetent children that usually occurs after infection of the lower airways. While a diagnosis of BO was usually confirmed by lung biopsy, identification of prior lung lesion plus a typical clinical course and a suggestive chest X-ray and CT scan have replaced the need for more invasive procedures.</p><p id="sp0040" class="elsevierStyleSimplePara elsevierViewall">The authors reviewed the clinical records of 10 BO patients, followed in the Outpatients Paediatric Pulmonology Unit from January 1997 to December 2002, to identify the most common aetio-logy, clinical and radiological profiles, treatment and course.</p><p id="sp0045" class="elsevierStyleSimplePara elsevierViewall">All patients maintained cough and/or wheezing after the initial acute episode. 80% had failure to thrive at the time of the diagnosis, mean age 16 months. Viral pneumonia was the main initial event (5 adenovirus, 3 respiratory syncytial virus, 1 parainfluenza virus, 1 unknown). Lung biopsies were not performed as clinical and radiological presentations were typical of BO. The follow-up (mean 36 months) revealed clinical resolution in 3 children and persistent symptoms in 6. One patient had progressive respiratory failure and died.</p><p id="sp0050" class="elsevierStyleSimplePara elsevierViewall">Prompt recognition of the diagnosis with supportive treatment that included oxygen therapy and an aggressive nutrition plan helped to improve the clinical state of the children.</p><p id="sp0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2007; XIII (4): 495-509</span></p></span>" ] ] "lecturaRecomendada" => array:1 [ 0 => array:3 [ "vista" => "all" "titulo" => "<span class="elsevierStyleSectionTitle" id="st0025">Bibliografia / Bibliography</span>" "seccion" => array:1 [ 0 => array:2 [ "vista" => "all" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bb0005" "etiqueta" => "1." 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Article information
ISSN: 08732159Original language: Portuguese
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