Abstract:
:Plastic bronchitis (PB) is an uncommon, potentially fatal disease, marked by endobronchial cast formation causing variable degrees of respiratory distress. Primary and secondary pulmonary lymphatic abnormalities have been identified among the underlying mechanisms of cast formation. We present a case of PB where lymphoscintigraphy demonstrated the underlying lymphatic defect. A 6-year-old Hispanic male with congenital heart disease (CHD; post-Fontan) presented with recurrent pneumonia, respiratory distress. Bronchoscopy showed inflamed hypervascular mucosa and thick mucus plugs; no casts were seen. Later, PB was diagnosed after the patient expectorated a bronchial cast. Cast analysis showed lymphocytic aggregates with mucin and fibrin. Lymphoscintigraphy revealed abnormal lymphatic collaterals and retrograde trace reflux into the superior mediastinum, a picture consistent with thoracic duct lymph leakage into the tracheobronchial tree. The pathogenesis of PB is not fully understood, especially in patients with CHD. Chyle in bronchial casts suggests abnormal lymphatic flow. Reports of lymph flow abnormalities, especially endobronchial lymph leakage in CHD are limited. Lymphoscintigraphy in our case demonstrated clear evidence of retrograde lymph reflux and leakage into the bronchial tree. The case presented suggests that in some patients following Fontan surgery, high intrathoracic lymphatic pressure and retrograde lymph flow may contribute to recurrent cast formation. Finding the underlying lymphatic abnormality helps in specific case management. Lymphoscintigraphy is a safer and easier method than lymphangiography. Surgical lymphatic-venous shunting may be possible in select cases.
journal_name
Pediatr Pulmonoljournal_title
Pediatric pulmonologyauthors
Ezmigna DR,Morgan WJ,Witte MH,Brown MAdoi
10.1002/ppul.22673subject
Has Abstractpub_date
2013-05-01 00:00:00pages
515-8issue
5eissn
8755-6863issn
1099-0496journal_volume
48pub_type
杂志文章abstract:OBJECTIVES:To investigate the adherence and the self-reported barriers to general and respiratory exercises reported by individuals with cystic fibrosis (CF). STUDY DESIGN:An exploratory, experimental study. METHODS:Community-dwelling individuals aged 16 years and over, diagnosed with CF, who were accompanied in refe...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24912
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Multiple breath washout (MBW) in infants presents a number of technical challenges. Conventional MBW is based on simultaneous measurement of flow and gas concentrations. These two signals are aligned and combined to derive expired gas volumes from which lung volumes and measures of ventilation inhomogeneity ...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23348
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVES:Forced expiratory volume in 1 second (FEV1) is an important predictor of outcome in cystic fibrosis (CF). This study aimed to describe the change in lung function, nutritional status, and mortality of children with CF at a single center in Cape Town, South Africa, and identify factors associated with poor lu...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24726
更新日期:2020-06-01 00:00:00
abstract::Airway obstruction in children is a rare, but difficult clinical problem, with no clear agreement on optimal therapeutic approach. Stenting of the airway has been used successfully in adults, and is an attractive alternative in children. Fundamental differences of pediatric compared to adult use include the benign nat...
journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.20790
更新日期:2008-04-01 00:00:00
abstract::A variety of postnatal therapies have been and will be evaluated for prevention or treatment of neonatal chronic lung disease (CLD). A simple method for early selection of the highest risk infants would optimize intervention trials. Our study compared a clinical scoring system for predicting neonatal CLD (defined at 3...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/(sici)1099-0496(199906)27:6<388::aid-ppul5
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:To review 15-year trends in respiratory care of extremely preterm infants managed in a tertiary perinatal center; to identify the factors contributing to their evolution; and to determine whether these changes had an impact on infant mortality, severe morbidity, and growth. METHODS:Retrospective cohort stud...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24774
更新日期:2020-08-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20403
更新日期:2006-06-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/(sici)1099-0496(199808)26:2<101::aid-ppul5
更新日期:1998-08-01 00:00:00
abstract::Atrial natriuretic peptide (ANP) has known natriuretic, diuretic, and vasodilatatory effects. It is synthesized and stored in the atrial cells. Stretching of the atrial muscle fibers during an increase in venous return sets a response of ANP release into the blood stream. High levels of ANP were measured in a number o...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20233
更新日期:2005-10-01 00:00:00
abstract::Episodes of respiratory distress with chest retraction and wheezing, sometimes associated with facial edema, were noted after administering the proton pump inhibitors omeprazole and esomeprazole in an infant with gastroesophageal reflux. The disturbances relieved dramatically after withdrawing the proton pump inhibito...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.20616
更新日期:2007-06-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章,评审
doi:10.1002/ppul.20251
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Prone sleeping position, use of soft mattresses and head covering by bedclothes are known risk factors for sudden infant death syndrome (SIDS). Rebreathing carbon dioxide (CO(2) ) may be a possible mechanism or a confounding factor of SIDS. OBJECTIVE:To compare the aeration properties of a new concept of in...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21351
更新日期:2011-02-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.22664
更新日期:2013-01-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24473
更新日期:2019-11-01 00:00:00
abstract::Nicotine, 1 mg/kg body weight/day, was injected subcutaneously in 3 female rabbits during gestational and lactating periods, and the lungs of the offspring were studied by scanning and transmission electron microscopy (SEM and TEM) on days 5, 10, and 25 postpartum. Three other female rabbits served as controls. The si...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950010606
更新日期:1985-11-01 00:00:00
abstract::In contrast to its effect on airway smooth muscle in the adult, in vitro studies have shown that caffeine significantly increases active tension in airway smooth muscle in the neonatal lamb. To determine if caffeine has a physiological effect on airway function during early development, we studied the effect of caffei...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950120106
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND:In young children with cystic fibrosis (CF) the forced expiratory volume in 1 second (FEV1 ) is often normal and a more sensitive measure to detect early obstructive lung disease is needed. AIM:To evaluate the progression of selected spirometry parameters with age in a cohort of CF patients and healthy chil...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.22777
更新日期:2013-11-01 00:00:00
abstract::Pneumogram (PG) recordings were performed in 87 very low birthweight (VLBW) asymptomatic infants just prior to hospital discharge to determine the relationships between: 1) a prior history of apnea of prematurity (AOP) and cardiorespiratory pattern; and 2) cardiorespiratory pattern at hospital discharge and postconcep...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1950040204
更新日期:1988-01-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24889
更新日期:2020-08-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.21111
更新日期:2009-11-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24313
更新日期:2019-06-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.23681
更新日期:2018-01-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24123
更新日期:2018-12-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1987-09-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.1027
更新日期:2001-03-01 00:00:00
abstract:AIM:Our aim was to evaluate the correlation of Adenosine monophosphate challenge test (AMP-PCW) results with the patients' subsequent clinical course. METHODS:We performed a 6-year retrospective cohort study of young children with suspected asthma who underwent AMP-PCW test. RESULTS:Fifty four children were included ...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24337
更新日期:2019-07-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章,多中心研究
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更新日期:2002-06-01 00:00:00
abstract:OBJECTIVE:The study was designed to assess the use of newer sidestream microstream end tidal carbon dioxide (ETCO(2) ) device in predicting blood carbon dioxide (PCO(2) ) measurements in very low birth weight (VLBW = birth weight <1,500 g) and non-VLBW NICU neonates. STUDY DESIGN:Sidestream microstream ETCO(2) detecto...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.22593
更新日期:2013-03-01 00:00:00
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journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/ppul.24622
更新日期:2020-03-01 00:00:00
abstract::SUMMARY. The detection of early airway disease in infants with cystic fibrosis (CF) may lead to earlier intervention and an improved prognosis. We hypothesized that the ratio of maximal expiratory flows while breathing a mixture of helium and oxygen (heliox) and air, referred to as density dependence (DD), would ident...
journal_title:Pediatric pulmonology
pub_type: 杂志文章
doi:10.1002/1099-0496(200101)31:1<17::aid-ppul1002>3.0
更新日期:2001-01-01 00:00:00