Follow-up on pediatric patients with bronchiolitis obliterans treated with corticosteroid pulse therapy

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art_TOMIKAWA_Followup_on_pediatric_patients_with_bronchiolitis_obliterans_treated_2014.PDF (980.35 KB)
Citações na Scopus
26
Tipo de produção
article
Data de publicação
2014
Editora
BIOMED CENTRAL LTD
DOI
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Scopus
Web of Science
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Título do Volume
Autores
TOMIKAWA, Silvia Onoda
LEONE, Claudio
Autor de Grupo de pesquisa
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Citação
ORPHANET JOURNAL OF RARE DISEASES, v.9, article ID 128, 10p, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: Bronchiolitis obliterans (BO) is a rare but severe disease in children. Currently, there is no consensus on the treatment for BO with respect to the systemic use of corticosteroids. Here we report on the follow-up of children with a diagnosis of BO who were treated with corticosteroid pulse therapy. Methods: Forty patients fulfilling the BO diagnosis criteria were treated with methylprednisolone pulse therapy in monthly cycles until clinical improvement. After the pulse therapy began, we analyzed the clinical and laboratory data at intervals. Statistical analyses were performed using non-parametric tests to compare repeated measures (Friedman, Wilcoxon) or paired nominal data (McNemar) (a = 5%). Results: The frequency of wheezing exacerbations and hospitalizations was reduced (p = 0.0042 and p < 0.0001, respectively) and oxygen saturation improved (p = 0.0002) in the pulse therapy-treated patients. Prolonged oral corticosteroid therapy was discontinued in 83% of these patients. The mean Z-score length for age improved from -1.08 to -0.63, and the mean Z-score weight for age improved from -0.91 to -0.59. The adverse effects during the infusion were temporary and none were serious. Conclusions: Our data suggest that pulse corticotherapy could be a safe alternative to prolonged systemic oral corticotherapy in children with BO, thus minimizing the adverse effects of the oral therapy. New prospective controlled studies are required to confirm this proposition.
Palavras-chave
Bronchiolitis obliterans, Pulse therapy, Methylprednisolone
URI
https://observatorio.fm.usp.br/handle/OPI/8806
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Coleções
Artigos e Materiais de Revistas Científicas - LIM/36
Artigos e Materiais de Revistas Científicas - HC/ICr