Perhimpunan Dokter Paru Indonesia - Misdiagnosed asthma may mask the bronchiolitis obliterans
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Misdiagnosed asthma may mask the bronchiolitis obliterans

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image: medical-malpractice.cmalaw.net

Ayse Tana Aslan1, Tugba Sismanlar1, Sevgi Pekcan2, Mehmet Kose3, Isil Irem Budakoglu4 and Bahar Gktrk5
1Pediatric Pulmonology, Gazi University Medicine Faculty, Ankara, Turkey, 2Pediatric Pulmonology, Necmettin Erbakan University Meram Medicine Faculty, Konya, Turkey, 3Pediatric Pulmonology, Erciyes University Medicine Faculty, Kayseri, Turkey, 4Medical Education, Gazi University Medicine Faculty, Ankara, Turkey, 5Pediatric Allergy and Immunology, Baskent University Medicine Faculty, Konya, Turkey

Introduction: Bronchiolitis obliterans (BO) is a rare, chronic lung disease, which results in fibrosis and irreversible obstruction of small airway. The most common cause is severe lower respiratory tract infection in children, named as post infectious bronchiolitis obliterans (PIBO). However, BO is often undiagnosed or misdiagnosed as other wheezing syndromes. Asthma and BO both have similar auscultation and spirometric findings and PIBO patients may be misdiagnosed as asthma. In this study we aimed to reveal the frequency of PIBO patients who were previously misdiagnosed as asthma and the delay of PIBO diagnosis in these patients.

Methods: Between 2007-2015, 39 PIBO patients were reviewed. Patients' ages, age of infection, symptoms, symptom duration, clinical and radiological findings, pulmonary function tests and asthma prediposing factors were compared between PIBO patients who were previously diagnosed as patients not previously diagnosed with asthma.

Results: The mean age of diagnose was 4.640.68 year and 18 (46%) of them were previously misdiagnosed as asthma. The mean age of diagnose, the mean symptom duration and oxygen need during the infection differed significantly between the 2 groups of patients (P < 0.05). Gender, hospitalization and mechanical ventilation duration, pulmonary function tests and asthma predisposing factors did not differ between the 2 groups.

Conclusion: PIBO is an uncommon chronic lung disease and the diagnosis requires strong doubt. Asthma is known as the most common chronic airway disease in children and may mask and delay the BO diagnosis in patients with chronic respiratory symptoms. To authors best knowledge, there is no other study that shows asthma misdiagnosis delay the PIBO diagnosis.

Source :
Image : http://www.medical-malpractice.cmalaw.net/images/articles/asthma-misdiagnosed.jpg

PDPI Malang. 27/07/17.

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