Pediatr Allergy Respir Dis.  2012 Sep;22(3):273-281.

Clinical Course of Eosinophilic Bronchitis in Children

• Kim YH
• Kim JD
• Park HB
• Baek J
• Kim KW
• Sohn MH
• Kim KE

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.

Keyword

Asthma; Child; Chronic cough; Eosinophilic bronchitis; Prognosis; Rhinosiusitis

MeSH Terms

Adrenal Cortex Hormones
Adult
Airway Obstruction
Asthma
Bronchitis
Child
Cough
Eosinophils
Humans
Inflammation
Nitric Oxide
Oscillometry
Prognosis
Respiratory Function Tests
Spirometry
Sputum
Adrenal Cortex Hormones
Nitric Oxide

Figure

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  Fig. 1 Diagram of the study subjects. RS (+), with rhinosinusitis; RS (-), without rhinosinusitis; ICS (+), with inhaled corticosteroid; ICS (-), without inhaled corticosteroid.

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  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.

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