Bronchoscopy Findings in Children with Asthma Symptoms

1. Bronchoscopy Findings in Children with Asthma Symptoms Özge Pamukçu, Z.S. Uyan, E. Çakır, S. Öktem, F. Karakoç, B. Karadağ, R. Ersu, E. Dağlı Marmara University Medical Faculty, Dep. of Pediatric Pulmonology,İSTANBUL

2. Introduction Persistent or recurrent wheezing in infancy is a common symptom. Prevalance of wheezing in infancy varies from 4 to 32% In wheezy children flexible bronchoscopy is indicated to evaluate associated anatomic and/or functional abnormalities. Flexible bronchoscopy is an important diagnostic tool in the differential diagnosis of wheezing and treatment plan of asthma.

3. Introduction Patients who respond poorly to corticosteroids, particularly those in whom unconventional therapies are being considered, should undergo bronchoscopy. This allows direct inspection of the airways and gives an opportunity for examination of the underlying pathology.

4. 29 of the 34 patients with persistent and/or recurrent wheezing whose symptoms recurred or did not improve despite bronchodilator and steroid treatment had functional and/or structural respiratory tract anomalies. Aslan Allergy and Asthma Nov 2005 A retrospective case series was reported in which bronchoscopy was used to investigate 30 young children with recurrent wheezing who had been poorly responsive to bronchodilators. Although they had been tentatively labeled as asthmatic patients, tracheomalacia was found in almost one-half of the cases. Schellhase J. Pediatrics 1998

5. In a recent study of 885 bronchoscopic procedures, 299 cases of malacia disorders (34%) were observed. Masters Pediatric Pulmonology 2002 In another study of 17 patients with onset of wheezing earlier than 6 months of age and a diagnosis of hyperreactive airway disease, bronchomalacia was detected in flexible bronchoscopy. Finder J. Pediatrics 1997

6. No complications had been observed after bronchoscopy of 36 asthmatic subjects. Humbert, Thorax BMJ 1996 Flexible bronchoscopy was performed to 48 children with Difficult asthma and 35 nonasthmatic children. The total number of perioperative complications was greater in the non-asthmatics undergoing flexible bronchoscopy than in the asthmatics. Payne, Arch Dis Child 2001

7. Aim To investigate the efficacy and the safety of bronchoscopy in children with persistent or recurrent wheezing.

8. Method We retrospectively reviewed the bronchoscopy results of 112 patients that have been followed for persistent or recurrent wheezing in our clinic.

9. Results Demographic characteristics of patients

10. Results The diagnosis of 40 % of the patients was changed after bronchoscopy; bronchoscopy results of 30 % of patients were normal

11. Results Bronchoscopy Results 26,5% 33.5% 12.4% 12.4% 2.7% 11.5%

15. Results 7,4% Minor complications No complications 92,6%

16. Results 5,6% 0,9% 0,9% 92,6% None of the patients had major complications

17. Conclusion Flexible bronchoscopy has an important role in the differential diagnosis of young patients who have asthma symptoms and it is a safe procedure without any major complications.

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