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High-resolution computed tomography findings in young infants with cystic fibrosis detected by newborn screening
Cohen, Renata Wrobel Folescu; Folescu, Tânia Wrobel; Boechat, Marcia Cristina Bastos; Fonseca, Vania Matos; Marques, Elizabeth Andrade; Leão, Robson Souza.
  • Cohen, Renata Wrobel Folescu; Universidade do Estado do Rio de Janeiro. Faculdade de Ciencias Medicas. Rio de Janeiro. BR
  • Folescu, Tânia Wrobel; Fundacao Instituto Oswaldo Cruz. da Crianca e do Adolescente Fernandes Figueira. Instituto Nacional de Saude da Mulher. Rio de Janeiro. BR
  • Boechat, Marcia Cristina Bastos; Fundacao Instituto Oswaldo Cruz. da Crianca e do Adolescente Fernandes Figueira. Instituto Nacional de Saude da Mulher. Rio de Janeiro. BR
  • Fonseca, Vania Matos; Fundacao Instituto Oswaldo Cruz. da Crianca e do Adolescente Fernandes Figueira. Instituto Nacional de Saude da Mulher. Rio de Janeiro. BR
  • Marques, Elizabeth Andrade; Universidade do Estado do Rio de Janeiro. Faculdade de Ciencias Medicas. Rio de Janeiro. BR
  • Leão, Robson Souza; Universidade do Estado do Rio de Janeiro. Faculdade de Ciencias Medicas. Rio de Janeiro. BR
Clinics ; 74: e1399, 2019. tab, graf
Article in English | LILACS | ID: biblio-1039546
ABSTRACT

OBJECTIVE:

High-resolution computed tomography (HRCT) allows the early detection of pathological changes in the lung structure, and reproducible scoring systems can be used to quantify chest computed tomography (CT) findings in patients with cystic fibrosis (CF). The aim of the study was to describe early HRCT findings according to a validated scoring system in infants with CF diagnosed by newborn screening (NBS).

METHODS:

This cross-sectional study included infants with CF diagnosed by NBS who were born between January 2013 and January 2017 and who underwent HRCT scanning within the first year after diagnosis when they were clinically stable. The CT scans were evaluated using the modified Bhalla score.

RESULTS:

Thirty-two subjects underwent HRCT scanning. The mean total-modified Bhalla score was 3.6±2.1, and 93.8% of the scans were abnormal. Pseudomonas aeruginosa airway colonization was associated with increased modified Bhalla score values. Bronchial wall thickening was the most common feature (90.6%), followed by bronchial collapse/consolidation (59.4%), mosaic attenuation/perfusion (50%), bronchiectasis (37.5%) and mucus plugging (15.6%). Bronchial wall thickening was diffuse in most of the patients.

CONCLUSION:

A substantial proportion of infants diagnosed with CF after detection by NBS already showed evidence of lung disease. P. aeruginosa colonization was associated with increased Bhalla scores, highlighting the importance of this CF pathogen in early structural lung disease. The presence of bronchial wall thickening at such a young age may reflect the presence of airway inflammatory processes. The detection and quantification of structural abnormalities with the modified Bhalla score may aid in the identification of lung disease before it is clinically apparent.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Neonatal Screening / Cystic Fibrosis Type of study: Diagnostic study / Observational study / Prevalence study / Prognostic study / Risk factors / Screening study Limits: Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Clinics Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Fundacao Instituto Oswaldo Cruz/BR / Universidade do Estado do Rio de Janeiro/BR

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Full text: Available Index: LILACS (Americas) Main subject: Neonatal Screening / Cystic Fibrosis Type of study: Diagnostic study / Observational study / Prevalence study / Prognostic study / Risk factors / Screening study Limits: Female / Humans / Infant / Male / Infant, Newborn Language: English Journal: Clinics Journal subject: Medicine Year: 2019 Type: Article Affiliation country: Brazil Institution/Affiliation country: Fundacao Instituto Oswaldo Cruz/BR / Universidade do Estado do Rio de Janeiro/BR