The course of plastic bronchitis in children

Full Text


Plastic bronchitis (PB) is a rare disease that occurs at any age patients with cardiovascular or pulmonary pathology. The pathogenesis of bronchial casts formation is not completely clear. Dense casts obturate the lumen of the bronchi, causing the formation of atelectasis. The extremely high heterogeneity of the clinical manifestations of plastic bronchitis makes timely diagnosis a difficult problem. Recommendations for the management of such patients have not been developed, the most effective and universal interventions are sanitation bronchoscopy and physical methods to restore the patency of the respiratory tract. The composition of inhalation nebulizer therapy is different, its use allows you to avoid relapses of the disease. The article provides a detailed review of modern descriptions of PB in children, a clinical case of PB in a 3-year-old child.

Full Text

Restricted Access

About the authors

Alexander B. Malakhov

Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

Ekaterina A. Yablokova

Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

Maksim I. Tkachev

Sechenov First Moscow State Medical University (Sechenov University)

Moscow, Russia

Irina V. Kovalenko

Morozov Children's City Clinical Hospital

Moscow, Russia

Irina A. Sokolina

Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Moscow, Russia


  1. Johnson SR, Sita-Lumsden EG. Plastic bronchitis. Thorax I960; 15: 325-32.
  2. Kunder R, Kunder C, Sun HY et al. Pediatric plastic bronchitis: case report and retrospective comparative analysis of epidemiology and pathology. Case Reports Pul-monol 2013; 2013: 649365. doi: 10.1155/2013/649365
  3. Caruthers RL, Kempa M, Loo A et al. Demographic characteristics and estimated prevalence of Fontan-associated plastic bronchitis. Pediatr Cardiol 2013; 34 (2): 256-61.
  4. Goldberg DJ, Dodds K, Rychik J. Rare problems associated with the Fontan circulation. Cardiol Young 2010; 20 (S3): 113-9.
  5. Allen KY, Downing TE, Glatz AC et al. Effect of Fontan-associated morbidities on survival with intact Fontan circulation. Am J Cardiol 2017; 119 (11): 1866-71.
  6. Schumacher KR, Singh TP, Kuebler J et al. Risk factors and outcome of Fontan associated plastic bronchitis: a case control study. J Am Heart Assoc 2014; 2 (2): e000865.
  7. Wiggins J, Sheffield E, Jeffery PK et al. Bronchial casts associated with hilar lymphatic and pulmonary lymphoid abnormalities. Thorax 1989; 44 (3): 226-7.
  8. Hug MI, Ersch J, Moenkhoff M et al. Chylous bronchial casts after Fontan operation. Circulation 2001; 103(7): 1031-3.
  9. Perez-Soler A. Cast bronchitis in infants and children. Am J Dis Child 1989; 143 (9): 1024-9.
  10. Panchabhai TS, Mukhopadhyay S, Sehgal S et al. Plugs of the air passages: a clinico-pathologic review. Chest 2016; 150 (5): 1141-57.
  11. ERS handbook of Paediatric Respiratory Medicine. 2013; p. 577-81.
  12. Орлов А.В., Кузьмина М.С., Желенина ЛА. и др. Четыре случая пластического бронхита у детей 2-7 лет. Лечение с использованием бронхоскопий, аэрозолей илопроста и 3% раствора NaCl. Вестн. Северо-Западного государственного медицинского университета им. И.И. Мечникова. 2014; 6 (2): 113-9.
  13. Pawar SS. Management of plastic bronchitis in a child with mild intermittent asthma. Ann Otol Rinol Laryngol 2011; 120 (11): 697-9.
  14. Madsen P, Shah SA, Rubin BK. Plastic bronchitis: new insights and a classification scheme. Paediatr Respirat Rev 2005; 6 (4): 292-300.
  15. Raghuram N, Pettignano R, Gal AA et al. Plastic bronchitis: an unusual complication associated with sickle cell disease and the acute chest syndrome. Pediatrics 1997; 100 (1): 139-42. doi: 10.1542/peds.100.1.139
  16. Jianhui Z, Kang X. Plastic bronchitis associated with influenza virus infection in children: a report on 14 cases. Int J Pediatr Otorhinolaryngol 2015; 79 (4): 481-6.
  17. Li Y, Williams RJ, Dombrowski ND et al. Current Evaluation and Management of Plastic Bronchitis in the Pediatric Population. Int J Pediatr Otorhinolaryngol 2020; 130: 109799. doi: 10.1016/j.ijporl.2019.109799
  18. Eberlein MH, Drummond MB, Haponik EF. Plastic bronchitis: a management challenge. Am J Med Sci 2008; 335 (2): 163-9.
  19. Healy F, Hanna BD, Zinman R. Pulmonary complications of congenital heart disease. Paediatr Respirat Rev 2012; 13 (1): 10-5.
  20. Seear M, Hui H, Magee F et al. 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 (1): 364-70. doi: 10.1164/ajrccm.155.1.9001337
  21. Languepin J, Scheinmann P, Mahut B et al. Bronchial casts in children with cardiopathies: the role of pulmonary lymphatic abnormalities. Pediatr Pulmonol 1999; 28 (5): 329-36.
  22. Hug MI, Ersch J, Moenkhoff M et al. Chylous bronchial casts after Fontan operation. Circulation 2001; 103 (7): 1031-3.
  23. Werkhaven J, Holinger LD. Bronchial casts in children. Ann Otol Rhinol Laryngol 1987; 96 (1): 86-92.
  24. Камалтынова Е.М., Кривощеков Е.В., Янулевич О.С., Кавардакова Е.С. Пластический бронхит, ассоциированный с корригированным пороком сердца у ребенка. Бюллетень сибирской медицины. 2017; 16 (2): 180-6.
  25. Biko DM, DeWitt AG, Pinto EM et al. MRI Evaluation of Lymphatic Abnormalities in the Neck and Thorax after Fontan Surgery: Relationship with Outcome. Radiology 2019; 291 (3): 774-80.
  26. Avitabile CM, Goldberg DJ, Dodds K et al. A multifaceted approach to the management of plastic bronchitis after cavopulmonary palliation. Ann Thorac Surg 2014; 98 (2): 634-40.
  27. Costello JM, Steinhorn D, McColley S et al. Treatment of plastic bronchitis in a Fon-tan patient with tissue plasminogen activator: a case report and review of the literature. Pediatrics 2002; 109 (4): e67.
  28. Heath L, Ling S, Racz J et al. Prospective, longitudinal study of plastic bronchitis cast pathology and responsiveness to tissue plasminogen activator. Pediatr Cardiol 2011; 32 (8): 1182-9.
  29. Onoue Y, Adachi Y, Ichida F et al. Effective use of corticosteroid in a child with life threatening plastic bronchitis after Fontan operation. Pediatr Int 2003; 45 (1): 107-9.
  30. Brooks K, Caruthers RL, Schumacher KR et al. Pharmacotherapy Challenges of Fon-tan Associated Plastic Bronchitis: A Rare Pediatric Disease. Pharmacotherapy 2013; 33 (9): 922-34.
  31. Quasney MW, Orman K, Thompson J et al. Plastic bronchitis occurring late after the Fontan procedure: treatment with aerosolized urokinase. Crit Care Med 2000; 28 (6): 2107-11.
  32. Kunder R, Kunder C, Sun HY et al. Pediatric plastic bronchitis: case report and retrospective comparative analysis of epidemiology and pathology. Case Rep Pulmo-nol 2013; 2013: 649365.
  33. Fairshter RD, Charles AR, Hewlett RI. Large bronchial casts. Arch Inter Med 1979; 139 (5): 522-5.
  34. Dori Y, Keller MS, Rome JJ et al. Percutaneous lymphatic embolization of abnormal pulmonary lymphatic flow as treatment of plastic bronchitis in patients with congenital heart disease. Circulation 2016; 133 (12): 1160-70.
  35. Rychik J, Atz AM, Celermajer DS et al. Evaluation and Management of the Child and Adult With Fontan Circulation: A Scientific Statement From the American Heart Association. Circulation 2019; 140 (6): 234-84.
  36. Скударнов Е.В., Лобанов Ю.Ф., Строзенко Л.А. и др. Пластический бронхит у ребенка (клиническое наблюдение). Мать и дитя в Кузбассе. 2020; 1 (80): 53-8. doi: 10.24411/2686-7338-2020-10010



Abstract: 59


Article Metrics

Metrics Loading ...



  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies