Misdiagnosis of Asthma May Delay the Post Infectious Bronchiolitis Obliterans Diagnosis

Aim: Asthma and Post infectious bronchiolitis obliterans (PIBO) have similar clinical findings and PIBO patients may have misdiagnosed as asthma previously. In this study we investigated the clinical features of PIBO patients and the causes in the delay of the correct diagnosis. Method: Sixty four patients diagnosed with PIBO followed up between years 2007 and 2018 in four pediatric centers. Twenty two of 64 patients were misdiagnosed as asthma previously. Patients’ age, symptom duration, asthma predisposing factors, clinical and spirometric findings between PIBO patients misdiagnosed as asthma and non-asthma diagnosed PIBO patients were compared. Results: Adenovirus was the most common infectious agent in the children with PIBO. During 32.6±4.6 months of follow up 22 (34.4%) patients were misdiagnosed with asthma. Not only the age of diagnosis of patients with asthma misdiagnosis was found significantly longer than non-asthma diagnosed patients (p<0.05) but also symptom duration was significantly longer in misdiagnosed with asthma patients (p<0.05). There were no statistical differences in gender, history of prematurity, smoking exposure, hospitalization duration, treatment duration, history of oxygen support and mechanical ventilation duration, asthma predisposing findings between two groups. Conclusion: PIBO patients misdiagnosed as asthma, diagnosed later than expected and had longer symptom duration. The similarity of symptoms and clinical response to inhaled beta 2 agonists and steroid treatment in asthma and PIBO could be the reason for misdiagnosis. Because of the resemblance between the two diseases, PIBO patients may misdiagnosed as asthma previously.