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CORRESPONDENCE paediatric cohort of patients with postin- mean increase per year during childhood Thorax: first published as 10.1136/thoraxjnl-2015-206998 on 28 April 2015. Downloaded from fectious obliterans (BO). The as done in the abstract. authors concluded that pulmonary func- Radiographic patterns of tion remained severely impaired, showing Martin Rosewich, Jonas Eckrich, Stefan Zielen acute chest syndrome an obstructive pattern with air trapping Department of Allergy, and , ’ that slowly improved during childhood. Children s Hospital, Goethe-University, Frankfurt am Main, Germany Dear editor, In addition, they showed that nine (19%) We read with great interest the year in patients developed thoracic deformity and Correspondence to Dr Martin Rosewich, Department of Allergy, Pulmonology and Cystic Fibrosis, Children’s review 2014 by Andy Bush and Ian seven (15.2%) . On the first 1 Hospital, Goethe-University, Theodor-Stern-Kai 7, Pavord on paediatric and adult clinical view, contrary to their findings, the FVC 60590 Frankfurt am Main, Germany; Martin. 2 studies. While discussing our paper, the and FEV1 increased by a mean of 11%/ [email protected] reviewer seems to have misinterpreted our year (95% CI 9.3% to 12.6%; p<0.0001) results when saying that consolidation is Contributors All authors did substantial contributions and 9%/year (95% CI 7.7% to 10.2%; to the conception of the work, took part in the more severe in the apex of adult sickle p<0.0001) during childhood. This is acquisition, analysis and interpretation of data. They cell disease patients with acute chest syn- quite difficult to understand since the drafted the work and did the final approval. The drome. In fact, CT and bedside chest radi- authors did report the increase in authors are accountable for all aspects of the work. ography showed that lung parenchyma volume in per cent only, but not in litre Funding Starke Lunge Foundation. was increasingly consolidated from apex (L). Still, their findings are in good Competing interests None declared. 2 to base. This distribution is in accordance accordance with our findings in BO. 34 Ethics approval Ethics Committee of with previous studies, but may vary We have recently characterised a cohort Goethe-University clinic. with age, with young children having of 16 patients with BO aged median 13.3± Provenance and peer review Not commissioned; more upper and middle lobe disease, con- 4.6 years and measured their lung func- internally peer reviewed. 3 trarily to adult patients. tion prospectively over 24 months by 48 plethysmographies (three measurements Armand Mekontso Dessap in each patient). Of these patients, nine Correspondence to Professor Armand Mekontso were in the period of growth. Dessap, AP-HP, Hôpitaux Universitaires Henri Mondor, fi DHU A-TVB, Service de Réanimation Médicale; UPEC, Our data con rmed that BO patients To cite Rosewich M, Eckrich J, Zielen S. Thorax Faculté de Médecine, Groupe de recherche clinique had significantly lower lung function 2015;70:792. CARMAS; 51 Av Mal deLattre de Tassigny, Créteil, (FVC, FEV1, FEV1/VC, MEF25 and Received 3 March 2015 Cedex 94 010, France; [email protected] increased residual volume (RV) and RV/ Accepted 9 April 2015 TLC (total lung capacity) values) as age- Published Online First 28 April 2015 Competing interests None declared. matched controls. Provenance and peer review Not commissioned; As shown in table 1, lung function of internally peer reviewed. patients during growth period remained

stable when expressed as predicted level http://thorax.bmj.com/ ▸ of normal. But there was a significant http://dx.doi.org/10.1136/thoraxjnl-2015-207112 increase in lung growth by a mean of Thorax 2015;70:792. FVC 0.3 L (14.1%) and FEV1 0.19 L To cite Mekontso Dessap A. Thorax 2015;70:792. doi:10.1136/thoraxjnl-2015-206998 (13.3%) in the first year and FVC 0.08 L Received 21 March 2015 (3.98%) and FEV1 0.03 L (2.09%) in the Accepted 25 March 2015 second year indicating that lung growth REFERENCE Published Online First 13 April 2015 1 Colom AJ, Maffey A, Bournissen FG, et al. Pulmonary is clearly related to growth velocity. Thorax function of a paediatric cohort of patients with 2015;70:792. on September 26, 2021 by guest. Protected copyright. doi:10.1136/thoraxjnl-2015-207088 Therefore, to avoid misunderstanding, postinfectious bronchiolitis obliterans. A long term lung growth should not be expressed as follow-up. Thorax 2015;70:169–74. REFERENCES 1 Bush A, Pavord I. Year in review 2013: paediatric and adult clinical studies. Thorax 2015;69:309–11. 2 Mekontso Dessap A, Deux JF, Habibi A, et al. Lung imaging during acute chest syndrome in : computed tomography patterns and diagnostic accuracy of bedside chest radiograph. Table 1 Lung function of growing patients with BO (n=9) Thorax – 2014;69:144 51. Initial Follow-up Follow-up Delta et al 3 Vichinsky EP, Styles LA, Colangelo LH, . Acute presentation 12 month 24 months change chest syndrome in sickle cell disease: clinical presentation and course. Cooperative Study of Sickle Age (years) 10.9 11.9 12.9 2 Cell Disease. Blood 1997;89:1787–92. Length 143.3 148.6 153.0 9.7 4 Mekontso Dessap A, Deux JF, Abidi N, et al. Pulmonary artery thrombosis during acute chest syndrome in sickle cell FVC (%) 77.61 81.38 79.69 2.08 disease. AmJRespirCritCareMed2011;184:1022–9. FVC (L) 2.01 2.31 2.39 0.38

FEV1 (%) 65.86 69.21 65.19 −0.67

Long-term lung function in FEV1 (L) 1.43 1.62 1.65 0.22 − postinfectious bronchiolitis FEV1/VC 70.17 70.78 67.80 2.37 RV (%) 162.98 220.31 173.71 10.72 obliterans RV/TLC 42.07 46.26 40.42 −1.65 We read with great interest the paper by Data are shown as mean. Colom et al1 on pulmonary function of a BO, bronchiolitis obliterans; RV, residual volume; TLC, total lung capacity; VC, vital capacity.

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