Abstract
Aim:
To investigate whether corticosteroids are effective in the treatment of plastic bronchitis with hemoptysis.
Methods:
A retrospective, clinical study was undertaken. Thirty two patients with only first episodes of plastic bronchitis with hemoptysis were divided into a steroid group (n=18) treated with glucocorticoids, and a non-steroid group (n=14). The supportive therapy was uniformly applied to both groups, except for glucocorticoids. Variables such as temperature and white blood cell counts were determined. Furthermore, the volume of hemoptysis and bronchial casts were evaluated in detail daily.
Results:
There was no difference in the demographic data and variables at baseline between both groups (all P > 0.05). On days 5, 6, 7 and 8, the volume of hemoptysis was significantly decreased in the steroid group compared with the non-steroid group (43±15 mL vs 117±33 mL on d 5, 29±12mL vs 97±23mL on d 6, 18 ± 10mL vs 80 ± 20mL on d 7, and 13 ± 8 mL vs 66±14 mL on d 8; all P<0.05), and on d 10 after fibreoptic bronchoscopy, the cases with bronchial casts was reduced evidently in the steroid group in comparison with the non-steroid group (OR=5.69,95% CI=1.76–43.6; P=0.005). There was no significance in mechanical ventilation and mortality between both groups.
Conclusion:
Despite some limitations of this study, it has been demonstrated that, on the basis of common supportive therapy, corticosteroids would be effective and safe for the treatment of plastic bronchitis with hemoptysis.
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Bowen A, Oudjhane K, Odagiri K, Liston SL, Cumming WA, Oh KS . Plastic bronchitis: large, branching, mucoid bronchial casts in children. Am J Roentgenol 1985; 144: 371–5.
Brogan TV, Finn LS, Pyskaty DJ Jr, Redding GJ, Ricker D, Inglis A, et al. Plastic bronchitis in children: a case series and review of the medical literature. Pediatr Pulmonol 2002; 34: 482–7.
Studer SM, Terry PB . Images in clinical medicine: bronchial cast. N Engl J Med 2002; 346: 981.
Liston SL, Proto D, Siegel LG . Plastic bronchitis. Laryngoscope 1986; 96: 1347–51.
Kao NL, Richmond GW . Cough productive of casts. Ann Allergy Asthma Immunol 1996; 76: 231–3.
Fairshter RD, Riley CA, Hewlett RI . Large bronchial casts. Arch Intern Med 1979; 139: 522–5.
Moser C, Nussbaum E, Cooper DM . Plastic bronchitis and the role of bronchoscopy in the acute chest syndrome of sickle cell disease. Chest 2001; 120: 608–13.
Ishman S, Book DT, Conley SF, Kerschner JE . Plastic bronchitis: an unusual bronchoscopic challenge associated with congenital heart disease repair. Int J Pediatr Otorhinolaryngol 2003; 67: 543–8.
Tzifa A, Robards M, Simpson JM . Plastic bronchitis: a serious complication of the Fontan operation. Int J Cardiol 2005; 101: 513–4.
Seear M, Hui H, Magee F, Bohn D, Cutz E . Bronchial casts in children: a proposed classification based on nine cases and review of the literature. Am J Respir Crit Care Med 1997; 155: 364–70.
Schultz KD, Oermann CM . Treatment of cast bronchitis with low-dose oral azithromycin. Pediatr Pulmonol 2003; 35: 139–43.
Shinkai M, Rubin BK . Macrolides and airway inflammation in children. Paediatr Respir Rev 2005; 6: 227–35.
Quasney MW, Orman K, Thompson J, Ring JC, Salim M, Schoumacher RA, et al. Plastic bronchitis occurring late after the Fontan procedure: treatment with aerosolized urokinase. Crit Care Med 2000; 28: 2107–11.
Manna SS, Shaw J, Tibby SM, Durward A . Treatment of plastic bronchitis in acute chest syndrome of sickle cell disease with intratracheal rhDNase. Arch Dis Child 2003; 88: 626–7.
Onoue Y, Adachi Y, Ichida F, Miyawaki T . Effective use of corticosteroid in a child with life-threatening plastic bronchitis after Fontan operation. Pediatr Int 2003; 45: 107–9.
Costello JM, Steinhorn D, McColley S, Gerber ME, Kumar SP . Treatment of plastic bronchitis in a Fontan patient with tissue plasminogen activator: a case report and review of the literature. Pediatrics 2002; 109: e67.
Madsen P, Shah SA, Rubin BK . Plastic bronchitis: new insights and a classification scheme. Paediatr Respir Rev 2005; 6: 292–300.
Yuan YM, Wang YJ . Plastic bronchitis with hemoptysis: a case report. West China Med J 1998; 13: 404. Chinese.
Werkhaven J, Holinger LD . Bronchial casts in children. Ann Otol Rhinol Laryngol 1987; 96 (1pt1): 86–92.
World Medical Association. Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2000; 284: 3043–5.
Jett JR, Tazelaar HD, Keim LW, Ingrassia, TS 3rd. Plastic bronchitis: an old disease revisited. Mayo Clin Proc 1991; 66: 305–11.
Muller, W, von der Hardt, H, Rieger CH . Idiopathic and symptomatic plastic bronchitis in childhood: a report of three cases and review of the literature. Respiration 1987; 52: 214–20.
Zhang TH, Hou SY . A death case with plastic bronchitis. J Clin Pulmonary Med 2005; 10: 118.
Tsang KW, Tipoe GL . Bronchiectasis: not an orphan disease in the East. Int J Tuberc Lung Dis 2004; 8: 691–702.
Tocque K, Bellis MA, Tam CM, Chan SL, Syed Q, Remmington T, et al. Long-term trends in tuberculosis: comparison of age-cohort data between HongKong and England and Wales. Am J Respir Crit Care Med 1998; 158: 484–8.
Tsang KW, Tan KC, Ho PL, Ooi GC, Ho JC, Mak J, et al. Inhaled fluticasone in bronchiectasis: a 12 month study. Thorax 2005; 60: 239–43.
Smego RA, Ahmed N . A systematic review of the adjunctive use of systematic corticosteroids for pulmonary tuberculosis. Int J Tuberc Lung Dis 2003; 7: 208–13.
Cole PJ . Inflammation: a two edged-sword - the model of bronchiectasis. Eur J Respir Dis Suppl 1986; 147: 6–15.
Park JY, Elshami AA, Kang DS, Jung TH . Plastic bronchitis. Eur Respir J 1996; 9: 612–4.
Sackett DL . Rules of evidence and clinical recommendations on the use of antithrombotic agents. Chest 1986; 89( 2 suppl): 2S–3S.
Guyatt G . Evidence-based medicine: past, present and future. Chin J Evidence-based Med 2004; 4: 3–7.
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Wang, G., Wang, Yj., Luo, Fm. et al. Effective use of corticosteroids in treatment of plastic bronchitis with hemoptysis in Chinese adults. Acta Pharmacol Sin 27, 1206–1212 (2006). https://doi.org/10.1111/j.1745-7254.2006.00418.x
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DOI: https://doi.org/10.1111/j.1745-7254.2006.00418.x