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Lung transplantation for patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO) syndrome

Luh SP, Lee YC, Chang YL, Wu HD, Kuo SH, Chu SH

Clin Transplant, 1999 Dec;13(6):496-503.

Sauropus androgymus (SA), a vegetable of the Euphorbiaceae family, is a common food source in Malaysia. In Taiwan, over 30 patients have developed progressive respiratory failure after consuming the extract from raw SA leaves as a means of losing weight. Symptoms consistent with a severe obstructive ventilatory defect progressed, despite cessation of SA intake and treatment with bronchodilators, corticosteroids, cytotoxic agents and plasmaphresis. Five patients with end-stage Sauropus androgynus-induced bronchiolitis obliterans (SABO) syndrome underwent lung transplantation. There was no early mortality. One patient died of post-transplant lymphoproliferative disorder and another patient died of bronchial stenosis with infection, 5 and 3.5 months, respectively, post-transplantation. The remaining 3 patients have been followed from 29 to 34 months, with improved general condition and pulmonary function. Perfusion/ventilation scans revealed that these improvements were exclusively attributed to the functional grafts. We believe that lung transplantation is the only effective modality of treatment for patients with end-stage SABO syndrome.

Matched MeSH terms: Bronchiolitis Obliterans/etiology*; Bronchiolitis Obliterans/pathology; Bronchiolitis Obliterans/surgery*

Fulltext Bronchiolitis obliterans in children--a report of six cases

Omar AH, Manan A

Med J Malaysia, 1989 Sep;44(3):204-9.

PMID: 2626135

Six children who survived severe acute bronchiolitis in infancy and early childhood continued to have persistent symptoms of breathlessness, cough and wheeze resistant to bronchodilator therapy. Hyperinflation of the chest, widespread crepitations and rhonchi were persistent clinical features. Failure to thrive was a problem in most. At presentation clinical measles was diagnosed in one child and adenovirus titres were raised in another; the aetiological agents in the others were not known. Lung biopsy from the child with measles showed features of severe bronchiolitis. The clinical and radiological features and course of the illness were consistent with those of bronchiolitis obliterans. Although illness was prolonged the long term prognosis was satisfactory with the majority of children showing improved chest signs, growth and general health after four to eight years of follow up.

Matched MeSH terms: Bronchiolitis Obliterans/complications; Bronchiolitis Obliterans/diagnosis*; Bronchiolitis Obliterans/therapy

Bronchiolitis obliterans in children: clinical profile and diagnosis

Chan PW, Muridan R, Debruyne JA

Respirology, 2000 Dec;5(4):369-75.

PMID: 11192548

The aim of the study was to determine the clinical profile, aetiology and radiological categories in children diagnosed with bronchiolitis obliterans (BO).

Matched MeSH terms: Bronchiolitis Obliterans/etiology*; Bronchiolitis Obliterans/radiography*

Fulltext Epidemiology, clinical presentation and respiratory sequelae of adenovirus pneumonia in children in Kuala Lumpur, Malaysia

Li L, Woo YY, de Bruyne JA, Nathan AM, Kee SY, Chan YF, et al.

PLoS One, 2018;13(10):e0205795.

PMID: 30321228 DOI: 10.1371/journal.pone.0205795

OBJECTIVES: To describe the severity, human adenovirus (HAdV) type and respiratory morbidity following adenovirus pneumonia in children.

METHODOLOGY: Retrospective review of children under 12 years of age, admitted with HAdV pneumonia, between January 2011 and July 2013, in a single centre in Malaysia. HAdV isolated from nasopharyngeal secretions were typed by sequencing hypervariable regions 1-6 of the hexon gene. Patients were reviewed for respiratory complications.

RESULTS: HAdV was detected in 131 children of whom 92 fulfilled inclusion criteria. Median (range) age was 1.1 (0.1-8.0) years with 80% under 2 years. Twenty percent had severe disease with a case-fatality rate of 5.4%. Duration of admission (p = 0.02) was independently associated with severe illness. Twenty-two percent developed respiratory complications, the commonest being bronchiolitis obliterans (15.2%) and recurrent wheeze (5.4%). The predominant type shifted from HAdV1 and HAdV3 in 2011 to HAdV7 in 2013. The commonest types identified were types 7 (54.4%), 1(17.7%) and 3 (12.6%). Four out of the five patients who died were positive for HAdV7. Infection with type 7 (OR 8.90, 95% CI 1.32, 59.89), family history of asthma (OR 14.80, 95% CI 2.12-103.21) and need for invasive or non-invasive ventilation (OR 151.84, 95% CI 9.93-2.32E) were independent predictors of respiratory complications.

CONCLUSIONS: One in five children admitted with HAdV pneumonia had severe disease and 22% developed respiratory complications. Type 7 was commonly isolated in children with severe disease. Family history of asthma need for invasive or non-invasive ventilation and HAdV 7 were independent predictors of respiratory complications.

Matched MeSH terms: Bronchiolitis Obliterans/etiology; Bronchiolitis Obliterans/epidemiology

Chronic suppurative lung disease in a developing country: impact on child and parent

Nathan AM, Muthusamy A, Thavagnanam S, Hashim A, de Bruyne J

Pediatr Pulmonol, 2014 May;49(5):435-40.

PMID: 24482322 DOI: 10.1002/ppul.23001

To investigate the impact of chronic suppurative lung disease (CSLD) on growth and lung function in the child as well as quality of life of the child and parent.

Matched MeSH terms: Bronchiolitis Obliterans/complications; Bronchiolitis Obliterans/physiopathology*; Bronchiolitis Obliterans/psychology

Epidemiology of adenovirus respiratory infections among hospitalized children in Seremban, Malaysia

Foong Ng K, Kee Tan K, Hong Ng B, Nair P, Ying Gan W

Trans R Soc Trop Med Hyg, 2015 Jul;109(7):433-9.

PMID: 26038572 DOI: 10.1093/trstmh/trv042

There is scarcity of data regarding epidemiology and clinical aspects of human adenovirus acute respiratory infection (ARI) among children in developing countries.

Matched MeSH terms: Bronchiolitis Obliterans/etiology; Bronchiolitis Obliterans/epidemiology

Fulltext Sauropus androgynus (L.) Merr. Induced Bronchiolitis Obliterans: From Botanical Studies to Toxicology

Bunawan H, Bunawan SN, Baharum SN, Noor NM

Evid Based Complement Alternat Med, 2015;2015:714158.

PMID: 26413127 DOI: 10.1155/2015/714158

Sauropus androgynus L. Merr. is one of the most popular herbs in South Asia, Southeast Asia, and China where it was known as a slimming agent until two outbreaks of pulmonary dysfunction were reported in Taiwan and Japan in 1995 and 2005, respectively. Several studies described that the excessive consumption of Sauropus androgynus could cause drowsiness, constipation, and bronchiolitis obliterans and may lead to respiratory failure. Interestingly, this herb has been used in Malaysia and Indonesia in cooking and is commonly called the "multigreen" or "multivitamin" plant due to its high nutritive value and inexpensive source of dietary protein. The plant is widely used in traditional medicine for wound healing, inducing lactation, relief of urinary disorders, as an antidiabetic cure and also fever reduction. Besides these medicinal uses, the plant can also be used as colouring agent in food. This review will explore and compile the fragmented knowledge available on the botany, ethnobotany, chemical constitutes, pharmacological properties, and toxicological aspects of this plant. This comprehensive review will give readers the fundamental, comprehensive, and current knowledge regarding Sauropus androgynus L. Merr.

Matched MeSH terms: Bronchiolitis Obliterans

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