ATOPY AND CENTRAL AIRWAY STENOSIS IN INFA NTS WITH PERSISTENT WHEEZING

Objective: This study was done to analyze the frequency, type and loca tion of central airway stenosis in young infants with persistent wheez ing unresponsive to bronchodilators and its relationship with atopy. M ethods: Over a two year period (1992-1994) bronchoscopic procedures we re performed in children less than 18 months old, hospitalized in the Children's University Hospitals of Bochum and Koln with persistent whe ezing. Sex, age, atopy, duration of wheezing, previous therapy and bro nchoscopic findings were analyzed. Infants with foreign body aspiratio n, cystic fibrosis or chronic neonatal lung disease were excluded. Sta tistical analysis was performed using chi square test. Results: Bronch oscopy was executed in 43 infants and revealed stenosis of the main br onchus in 16, tracheomalacia in 12, tracheal compression in 4 and bron chial anomaly in 2 cases. Inflammatory changes only were found in 9 pa tients. The male/female sex ratio was 3 : 1. The mean duration of obst ructive airway symptoms was 5 months. More than one third of the cases received topical or systemic steroids. Atopy was present in 17 patien ts. Central airway stenosis showed a similar frequency in atopic and n on atopic infants. Conclusions: Bronchoscopy should be considered in a ll infants with persistent wheezing, including those with proven atopi c disposition, to facilitate early recognition and treatment of critic al central airway stenoses.