Objective To analyze the clinical characteristics of diffuse panbronchiolitis (DPB) in children and to enhance the clinical diagnosis and treatment of this disease. Methods A retrospective analysis was conducted on the clinical data of 6 children diagnosed with DPB who were hospitalized at The First Affiliated Hospital of Guangzhou Medical University from January 2011 to December 2019. Results Among the 6 patients, there were 2 males and 4 females; the age at diagnosis ranged from 7 to 12 years. All patients presented with cough, sputum production, and exertional dyspnea, and all had a history of sinusitis. Two cases showed positive serum cold agglutinin tests, and 5 cases exhibited pathological changes consistent with chronic bronchiolitis. High-resolution chest CT in all patients revealed centrilobular nodules diffusely distributed throughout both lungs with a tree-in-bud appearance. Five patients received low-dose azithromycin maintenance therapy, but 3 showed inadequate treatment response. After empirical anti-tuberculosis treatment, non-tuberculous Mycobacteria were found in the bronchoalveolar lavage fluid. Follow-up over 2 years showed 1 case cured, 3 cases significantly improved, and 2 cases partially improved. Conclusions The clinical presentation of DPB is non-specific and can easily lead to misdiagnosis. In cases where DPB is clinically diagnosed but does not show improvement with low-dose azithromycin treatment, special infections should be considered.
Key words
Diffuse panbronchiolitis /
Diagnosis /
Non-tuberculous Mycobacteria /
Child
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References
1 Li H, Zhou Y, Fan F, et al. Effect of azithromycin on patients with diffuse panbronchiolitis: retrospective study of 51 cases[J]. Intern Med, 2011, 50(16): 1663-1669. PMID: 21841323. DOI: 10.2169/internalmedicine.50.4727.
2 李英姬, 胡红, 工藤翔二. 弥漫性泛细支气管炎和大环内酯类药物疗法[J]. 中华结核和呼吸杂志, 2002, 25(7): 421-423. DOI: 10.3760/j:issn:1001-0939.2002.07.026.
3 尤小芳. CT对弥漫性泛细支气管炎诊断及疗效评价的临床研究[D]. 上海: 第二军医大学, 2012.
4 Benninger MS, Senior BA. The development of the Rhinosinusitis Disability Index[J]. Arch Otolaryngol Head Neck Surg, 1997, 123(11): 1175-1179. PMID: 9366696. DOI: 10.1001/archotol.1997.01900110025004.
5 黄建. 呼吸道症状评分在社区获得性肺炎治疗中的意义[J]. 中国基层医药, 2013, 20(17): 2670-2672. DOI: 10.3760/cma.j.issn.1008-6706.2013.17.049.
6 中华耳鼻咽喉头颈外科杂志编委会, 中华医学会耳鼻咽喉头颈外科学分会鼻科学组. 慢性鼻-鼻窦炎诊断和治疗指南[J]. 中国临床医生, 2010, 38(4): 73-74. DOI: 10.3969/j.issn.1008-1089.2010.04.030.
7 尤小芳, 史景云, 李秋红, 等. 儿童弥漫性泛细支气管炎3例分析并文献复习[J]. 中国实用儿科杂志, 2008, 23(12): 930-933.
8 王岚, 蔡柏蔷. 中国人弥漫性泛细支气管炎和冷凝集试验的探讨[J]. 基础医学与临床, 2009, 29(10): 1075-1078. DOI: 10.16352/j.issn.1001-6325.2009.10.022.
9 许惠娟, 宋梅, 方雪映, 等. 弥漫性泛细支气管炎患者肺通气不均指数水平及其应用价值[J]. 汕头大学医学院学报, 2017, 30(1): 22-25. DOI: 10.13401/j.cnki.jsumc.2017.01.009.
10 李菲, 王艳, 朱光发, 等. 弥漫性泛细支气管炎6例临床分析[J]. 心肺血管病杂志, 2018, 37(3): 193-196. DOI: 10.3969/j.issn.1007-5062.2018.03.005.
11 李惠萍, 何国钧. 弥漫性泛细支气管炎研究进展[J]. 国外医学（呼吸系统分册）, 2004, 24(2): 100-102. DOI: 10.3760/cma.j.issn.1673-436X.2004.02.014.
12 刘鸿瑞, 刘彤华, 任华. 弥漫性泛细支气管炎临床病理分析[J]. 中华病理学杂志, 2001, 30(5): 325-327. DOI: 10.3760/j.issn:0529-5807.2001.05.001.
13 Tsuji T, Tanaka E, Yasuda I, et al. Nontuberculous Mycobacteria in diffuse panbronchiolitis[J]. Respirology, 2015, 20(1): 80-86. PMID: 25269823. DOI: 10.1111/resp.12412.
14 陈秀平, 刘蓉, 武玉明, 等. 弥漫性泛细支气管炎合并非结核分枝杆菌病1例[J]. 中国实用内科杂志, 2006, 26(19): 1513. DOI: 10.3969/j.issn.1005-2194.2006.19.049.
15 Nakata K,Taguchi Y,Kudoh S. Therapeutic guidelines for DPB. Annual report on the study of diffuse lung disease in 1999[S]. Tokyo: Grant-in aid from the Ministry of Health and Welfare of Japan, 2000.
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