Clinical, radiological, and spirometric outcomes of pediatric bronchiolitis obliterans: A ten-year single-center experience

Abstract

Bronchiolitis obliterans (BO) is a chronic and irreversible obstructive lung disease in children. Due to nonspecific clinical manifestations and limited disease-modifying treatment options, BO remains a diagnostic and therapeutic challenge, and data describing long-term clinical, radiological, and functional outcomes are limited. This study aimed to retrospectively evaluate the pediatric patients with bronchiolitis obliterans at a tertiary pediatric pulmonology center. This retrospective descriptive study included children diagnosed with bronchiolitis obliterans and followed at the Pediatric Pulmonology Clinic of in a tertiary care center between January 2015 and January 2025. All data records were reviewed retrospectively. Demographic and clinical features, chest computed tomography (CT) findings, laboratory parameters, treatment modalities, and spirometric indices at baseline and follow-up were analyzed. Also, baseline and follow-up spirometry and CT findings were compared. The median age at diagnosis was 48 months (IQR, 39–66), and 57.6% of patients were male. At diagnosis, 38% of patients required supplemental oxygen. Chest CT revealed diffuse air trapping and mosaic attenuation in most of patients, with no statistically significant changes observed on follow-up imaging (p>.05). Baseline spirometry demonstrated an obstructive pattern, with a median FEV₁ of 66.0% predicted (IQR, 57.5–71.5). Follow-up spirometry showed persistently reduced lung function, with no statistically significant differences between baseline and follow-up values for FEV₁, FVC. BO in children is a chronic disease characterized by persistent respiratory symptoms, fixed airflow obstruction, and stable radiologic abnormalities. Current therapies may improve symptoms and reduce oxygen dependence in some patients but do not reverse established structural lung damage. Early diagnosis, regular pulmonary function monitoring, and a multidisciplinary approach are essential to optimize long-term outcomes.