Tuberc Respir Dis.  2012 Aug;73(2):122-126.

Plastic Bronchitis in an Adult with Asthma

• Kim EJ
• Park JE
• Kim DH
• Lee J

Abstract

Plastic bronchitis is a rare disease characterized by marked airway obstruction, via the formation of large gelatinous or rigid airway cast. In Korea, there were a few case reports with plastic bronchitis not in adults, but in children. So we report a case of an adult who was diagnosed as plastic bronchitis with eosinophilic casts, with no history of atopic and cardiac disease.

Keyword

Bronchitis; Etiology; Asthma; Adult

MeSH Terms

Adult
Airway Obstruction
Asthma
Bronchitis
Child
Eosinophils
Gelatin
Heart Diseases
Humans
Korea
Plastics
Rare Diseases
Gelatin
Plastics

Figure

• 

  Figure 1 (A) Initial chest X-ray shows no definite abnormalities. (B) After 2 months, chest X-ray shows infiltration at the left lower lung field. (C) After bronchoscopic removal of bronchial casts, chest X-ray shows a dramatically improvement of infiltration at the left lower lung fields.

• 

  Figure 2 Chest computed tomography shows multiple nodular infiltration at left upper lobe (A, B) and consolidation at left lower lobe (C, D), suggesting tuberculosis.

• 

  Figure 3 Bronchoscopic exam shows a hard purulent mass-like secretion at left lower lobe basal segment bronchus (A). Bronchoscopic removal of that mass reveals a large cast along bronchial tree (B).

• 

  Figure 4 Biopsy specimen of mass-like secretion shows mucous plug, containing necrotic epithelial cells, some eosinophils and Charcot-Leyden crystals (arrows) (H&E stain, ×400).

Reference

1. Liston SL, Porto D, Siegel LG. Plastic bronchitis. Laryngoscope. 1986. 96:1347–1351.

2. Madsen P, Shah SA, Rubin BK. Plastic bronchitis: new insights and a classification scheme. Paediatr Respir Rev. 2005. 6:292–300.

3. 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. 34:482–487.

4. Bowen A, Oudjhane K, Odagiri K, Liston SL, Cumming WA, Oh KS. Plastic bronchitis: large, branching, mucoid bronchial casts in children. AJR Am J Roentgenol. 1985. 144:371–375.

5. Park JY, Elshami AA, Kang DS, Jung TH. Plastic bronchitis. Eur Respir J. 1996. 9:612–614.

6. Cho YK, Oh SM, Choi WY, Song ES, Han DK, Kim YO, et al. Fatal plastic bronchitis with eosinophilic casts in a previously healthy child. Korean J Pediatr. 2009. 52:1048–1052.

7. Kim YH, Choi HJ, Kim JO, Hyun MC. Plastic bronchitis in children: 2 cases. Korean J Pediatr. 2009. 52:832–836.

8. Eberlein MH, Drummond MB, Haponik EF. Plastic bronchitis: a management challenge. Am J Med Sci. 2008. 335:163–169.

9. Seear M, Hui H, Magee F, Bohn D, Cutz E. Bronchial casts in children: a proposed classification based on nine cases and a review of the literature. Am J Respir Crit Care Med. 1997. 155:364–370.

10. Quysner A, Surani S, Roberts D. Plastic bronchitis. West J Emerg Med. 2011. 12:118–119.

11. Jett JR, Tazelaar HD, Keim LW, Ingrassia TS 3rd. Plastic bronchitis: an old disease revisited. Mayo Clin Proc. 1991. 66:305–311.

12. Wang G, Wang YJ, Luo FM, Wang L, Jiang LL, Mao B. Effective use of corticosteroids in treatment of plastic bronchitis with hemoptysis in Chinese adults. Acta Pharmacol Sin. 2006. 27:1206–1212.

13. Noizet O, Leclerc F, Leteurtre S, Brichet A, Pouessel G, Dorkenoo A, et al. Plastic bronchitis mimicking foreign body aspiration that needs a specific diagnostic procedure. Intensive Care Med. 2003. 29:329–331.

14. Rubin BK, Henke MO. Immunomodulatory activity and effectiveness of macrolides in chronic airway disease. Chest. 2004. 125:2 Suppl. 70S–78S.