Recurrent bronchitis as a clinical variant of functional changes of the respiratory system in children

Abstract

Background. The high prevalence of acute respiratory infections in children, recurrent episodes of acute bronchitis remain to be one of the hot topics of pediatrics. The causes of recurrent exacerbations of bronchitis in children, despite the numerous research works on this issue, are not completely clear. Aim: to study the features of the clinic in children with recurrent bronchitis. Methods. There were 58 patients aged 3 to 12 years with recurrent bronchitis. A study demonstrated the close relationship between recurrent episodes of acute bronchitis not only with pre-preschool and preschool age (when bronchopulmonary tissue is not completely differentiated), with the influence of negative environmental factors, with bacterial, viral infection, but also with signs of connective tissue disorders (CTD) in them. Results. Revealing connective tissue insufficiency explains the causes of disorders of bronchial cartilage and connective tissue, that lead to the development of bronchial dyskinesia thus exacerbating the vulnerability of immature bronchopulmonary tissue along with autonomic dysfunction, typical for CTD. Involvement of several organs and systems in the CTD process changes the course of clinical symptoms of recurrent bronchitis. Probably by the main differentiation of tissues of organs at this age, including connective tissue, can be explained the fact that in 2/3 of the children observed by the age of 7 the manifestations of exacerbations of the disease ceased. In the half of the patients with recurrent episodes, who had bronchial obstruction in the first year of life, a allergy history, paroxysms of respiratory dyspnoea after an additional examination, – asthma was diagnosed; in one patient an aneurysm of the lung vessels was revealed. Conclusions. Basing on the conducted study, the use of the term “recurrent bronchitis” is advisable in children of the first seven years of life. In patients with continuing episodes of bronchitis bronchopulmonary pathology should be excluded; in patients with allergy history and symptoms of bronchial obstruction, spasmodic cough in previous episodes of bronchitis asthma should be excluded. The presence of symptoms of connective tissue disorders in children with recurrent bronchitis requires a careful examination of patients for the detection of comorbid diseases.