Acta Pharmacologica Sinica 2006 September; 27 (9): 1206-1212; doi: 10.1111/j.1745-7254.2006.00418.x

Aim: To investigate whether corticosteroids are effective in the treatment of plastic bronchitis with hemoptysis.

Methods: A retrospective, clinical study was undertaken. Thirty two patients with only first episodes of plastic bronchitis with hemoptysis were divided into a steroid group (n=18) treated with glucocorticoids, and a non-steroid group (n=14). The supportive therapy was uniformly applied to both groups, except for glucocorticoids. Variables such as temperature and white blood cell counts were determined. Furthermore, the volume of hemoptysis and bronchial casts were evaluated in detail daily.

Results: There was no difference in the demographic data and variables at baseline between both groups (all P>0.05). On days 5, 6, 7 and 8, the volume of hemoptysis was significantly decreased in the steroid group compared with the non-steroid group (43±15 mL vs 117±33 mL on d 5, 29±12 mL vs 97±23 mL on d 6, 18±10 mL vs 80±20 mL on d 7, and 13±8 mL vs 66±14 mL on d 8; all P<0.05), and on d 10 after fibreoptic bronchoscopy, the cases with bronchial casts was reduced evidently in the steroid group in comparison with the non-steroid group (OR=5.69, 95% CI=1.76-43.6; P=0.005). There was no significance in mechanical ventilation and mortality between both groups.

Conclusion: Despite some limitations of this study, it has been demonstrated that, on the basis of common supportive therapy, corticosteroids would be effective and safe for the treatment of plastic bronchitis with hemoptysis.

Keywords: plastic bronchitis; clinical features; hemoptysis; corticosteroids; efficacy; safety