Clinical Course of Eosinophilic Bronchitis in Children

Yoon Hee Kim; Jong Deok Kim; Hyun Bin Park; Jiyoung Baek; Kyung Won Kim; Myung Hyun Sohn; Kyu-Earn Kim

doi:10.7581/pard.2012.22.3.273

Journal List > Pediatr Allergy Respir Dis > v.22(3) > 1033185

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Kim, Kim, Park, Baek, Kim, Sohn, and Kim: Clinical Course of Eosinophilic Bronchitis in Children

Original Article

Pediatric Allergy and Respiratory Disease

Pediatric Allergy and Respiratory Disease 2012; 22(3): 273-281.

Published online: 30 September 2012

DOI: https://doi.org/10.7581/pard.2012.22.3.273

Clinical Course of Eosinophilic Bronchitis in Children

Yoon Hee Kim, MD, Jong Deok Kim, MD, Hyun Bin Park, MD, Jiyoung Baek, MD, Kyung Won Kim, MD, PhD, Myung Hyun Sohn, MD, PhD, Kyu-Earn Kim, MD, PhD

Department of Pediatrics, Institute of Allergy, Severance Biomedical Science Institute, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea.

Corresponding author (jy10078@naver.com)

Received 30 April 2012 Revised 20 June 2012 Accepted 14 July 2012

Abstract

Purpose

It has been identified that eosinophilic bronchitis (EB) in adults can progress to asthma or fixed airway obstruction. In the present study, we evaluated the clinical course and prognosis of EB in children and their relationship with accompanying rhinosinusitis.

Methods

A total of 55 children with EB followed up for over than a year after the diagnosis were enrolled for the present study. We classified the subjects into two groups according to the prognosis and the presence of rhinosinusitis, respectively, and compared them with respect to clinical characteristics, eosinophil percentage in induced sputum, fractional exhaled nitric oxide (FeNO) and pulmonary function test. The poor prognostic group was defined as the children with asthma or asthma-like symptoms, or persistent or recurrent chronic cough in the long-term follow-up.

Results

The poor prognosis was achieved in 12 children (22%), and 3 children (5%) amongst them were diagnosed with asthma. There were no significant differences in clinical characteristics, eosinophil percentages in induced sputum, FeNO, spirometry and IOS according to the prognosis and the presence of rhinosinusitis. Additionally, the children with rhinosinusitis did not show any poorer outcome than those without rhinosinusitis.

Conclusion

There were some limitations of this study for which the relationship between EB and rhinosinusitis in children was evaluated. However, in case of either poor short-term response to inhaled corticosteroids or elevated eosinophilic inflammation in airways or abnormal airway reversibility in impulse oscillometry, the long-term prognosis of EB in children needs to be considered, regardless of the presence of rhinosinusitis.

Keywords: Asthma, Child, Chronic cough, Eosinophilic bronchitis, Prognosis, Rhinosiusitis

Figures and Tables

Fig. 1

Diagram of the study subjects. RS (+), with rhinosinusitis; RS (-), without rhinosinusitis; ICS (+), with inhaled corticosteroid; ICS (-), without inhaled corticosteroid.

Fig. 2

Comparison between the good and poor outcome groups in children with eosinophilic bronchitis. (A) Sputum eosinophil percentage (P=0.116) and FeNO (P=0.089). (B) Δ R5-R20 (P=0.430) and Δ X5 (P=0.696). The values were shown with the medians in sputum eosinophil percentage, FeNO and Δ X5. The values of Δ R5-R20 was shown with the mean. FeNO, fractional exhaled nitric oxide; Δ R5-R20, percentage change in difference in resistance between 5 Hz and 20 Hz; Δ X5, percentage change in reactance at 5 Hz.

Table 1

Clinical Characteristics between the Good and Poor Outcome Groups in Children with Eosinophilic Bronchitis

Values are presented as mean±SD, number (%) or median (interquartile range).

IgE, immunoglobulin E; ICS, inhaled corticosteroid

Table 2

Pulmonary Function Test between the Good and Poor Outcome Groups in Children with Eosinophilic Bronchitis

Values are presented as mean±SD or median (interquartile range).

FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; FEF_25-75, forced expiratory flow between 25 and 75%; BD, bronchodilator response.

Table 3

Clinical characteristics between the Rhinosinusitis and Non-Rhinosinusitis Groups in Children with Eosinophilic Bronchitis

Values are presented as mean±SD, number (%) or median (interquartile range). IgE, immunoglobulin E; ICS, inhaled corticosteroid.

Table 4

Pulmonary Function Test between the Rhinosinusitis and Non-Rhinosinusitis Groups in Children with Eosinophilic Bronchitis

Values are presented as mean±SD or median (interquartile range).

FEV₁, forced expiratory volume in 1 second; FVC, forced vital capacity; FEF_25-75, forced expiratory flow between 25 and 75%; BD, bronchodilator response; R5, resistance at 5 Hz; X5, reactance at 5 Hz; AX, reactance area; FeNO, fractional exhaled nitric oxide.

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