Postinfectious bronchiolitis obliterans masked by misdiagnosis as asthma

• Published in: Pediatric pulmonology 2020-04, Vol.55 (4), p.1007-1011
• Main Authors: Onay, Zeynep R., Ramasli Gursoy, Tugba, Aslan, Ayse T., Sismanlar Eyuboglu, Tugba, Kibar, Busra S., Pekcan, Sevgi, Hangul, Melih, Kose, Mehmet, Budakoglu, Isil I., Gokturk, Bahar
• Format: Article
• Language: English
• Subjects: Asthma; children; Lung diseases; Pediatrics; postinfectious bronchiolitis obliterans
• ISSN: 8755-6863; 1099-0496
• DOI: 10.1002/ppul.24690

Objectives Asthma and postinfectious bronchiolitis obliterans (PIBO) have similar clinical findings, and PIBO may be misdiagnosed with asthma. This study aimed to determine the clinical features of PIBO in children and the causes of delay in its diagnosis. Methods We retrospectively evaluated all patients diagnosed with PIBO in four pediatric pulmonology centers between 2007 and 2018. In total, 64 PIBO patients were retrospectively reviewed. We compared the clinical and laboratory differences between PIBO patients who had initially been misdiagnosed with asthma and correctly diagnosed with PIBO. Results Of the 64 patients, 22 (34.4%) had initially been misdiagnosed with asthma. Adenovirus was the most common infectious agent in children. The age upon diagnosis was older, and the symptom duration was significantly longer in patients misdiagnosed with asthma (P  .05). Conclusions Patients with PIBO who had initially been misdiagnosed with asthma were correctly diagnosed at older ages and had longer symptom duration. Asthma may mask PIBO diagnosis by the similarity of symptoms and the clinical response to inhaled β2‐agonist or steroid treatment. PFTs may not help clinicians because of the age of children. The delay in the diagnosis of PIBO is probably attributable to the fact that some clinicians fail to include PIBO in the differential diagnosis when there is no clinical response to asthma medication.