New procedure shown to help treat bronchial condition in adults

PHILADELPHIA, Jan. 10 (UPI) -- Researchers at the Children's Hospital of Philadelphia, or CHOP, are using new imaging and surgery techniques to successfully treat adults with plastic bronchitis.

Plastic bronchitis is a rare condition in which patients develop thick, caulk-like plugs, called casts, in the branching pathways of their lungs. Patients with plastic bronchitis complain of a chronic cough and/or asthma symptoms.

Doctors at CHOP developed new imaging tools and a minimally invasive catheterization technique to treat children with plastic bronchitis, but new research has shown that these same methods can be successfully used in adults with the same condition.

"In some cases, the cause of this condition is unknown, but this new study suggests that most adult patients with plastic bronchitis have abnormal pulmonary flow of lymphatic fluid that we can safely treat," Dr. Maxim G. Itkin, a radiologist at CHOP and the Perelman School of Medicine at the University of Pennsylvania and lead author of the study, said in a press release.

The study involved seven adults with a mean age of 50 years old with branching bronchial casts. Researchers used a customized type of magnetic resonance imaging called dynamic contrast-enhanced MR lymphangiography, or DCMRI, and found that six of the seven patients also had abnormal lymphatic flow, called pulmonary perfusion syndrome.

Doctors treated those patients with lymphatic embolization, a procedure that involves insertion of a combination of glue and coils through a catheter to stop the flow of lymphatic fluid.

The results showed that five patients reported immediate and complete resolution of their symptoms, while the sixth patient reported significant partial improvement.

"This was a small study, and a first report of this treatment in adults with lymphatic plastic bronchitis," Dr. Yoav Dori, pediatric cardiologist at CHOP and Penn Medicine, and co-author of the study, said in a press release. "Longer follow-up will be needed to confirm the long-term risks and benefits of this procedure."

The study was published in the Annals of the American Thoracic Society.
Amy Wallace

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