Characteristics of children with endoscopically proved chronic bronchitis
T. F. Smith, T. A. Ireland, G. S. Zaatari, B. B. Gay, G. T. Zwiren and H. G. Andrews
This study evaluated by chart review the clinical, allergic, pathologic,
and immunologic characteristics of 20 children found to have chronic
bronchitis (CB) by bronchoscopic evaluation, including 13 children in whom
CB was documented by endobronchial biopsy. Two additional children likely
to have had CB also are described. In this study group, all of the patients
were believed to have asthma as well. Chronic bronchitis was predicted by
chronicity of symptoms and incomplete response to bronchodilators and
corticosteroids, but it was not predicted by a history of allergy or
laboratory evidence of systemic infection or inflammation. In the children
described herein, CB often was associated with an IgG subclass abnormality.
Bronchoscopic evaluation documented CB and provided biopsy and secretion
samples. Although the histomorphic findings were heterogeneous, patients
with CB usually had white blood cells present on Gram stains of secretions
in addition to mononuclear cell infiltrates on biopsy specimens. Chronic
bronchitis in these children seems to be distinct from CB in adults.
Further studies will be needed to define CB in children.
