Sir,
We acknowledge the comments,[1] regarding our recent article in Lung India (2013 July-September).[2] Veras et al. in their report of plastic bronchitis (PB) in a child stated that PB exhibits variable clinical manifestations that are non-specific. Beta thalassemia minor also exhibits variable clinical manifestations.[3] The cause of PB is mainly respiratory, cardiac cyanotic and hematologic diseases[3] In our case, there was no definitive cause for PB. She did not have symptoms of asthma, or atopy in self or family. She was not symptomatic for sickle cell anemia or cystic fibrosis, hence sickling test and sweat chloride test was not done. The patient was previously diagnosed case of beta thalassemia minor as a part of work-up done for her daughter who has thalassemia major.
Cause and effect relationship between PB and thalassemia minor is yet to be established. However, PB may also occur due to infections.[4] Infections are seen with patients having hematological diseases including thalassemia minor.[5] This predisposition has been suggested as being related to some immunological defects and to an altered immunological reactivity.[5]
REFERENCES
1. Zaki SA. Plastic bronchitis in beta thalassemia minor Lung India. 2014;31:92–3
2. Yadav M, Tirpude S, Joshi JM. Plastic bronchitis in beta thalassemia minor Lung India. 2013;30:206–8
3. Veras TN, Lannes GM, Piva JP, Stein RT, Jones MH, Silva VD, et al Plastic bronchitis in a child with thalassemia alpha J Pediatr (Rio J). 2005;81:499–502
4. Hasegawa M, Inamo Y, Fuchigami T, Hashimoto K, Morozumi M, Ubukata K, et al Bronchial casts and pandemic (H1N1) 2009 virus infection Emerg Infect Dis. 2010;16:344–6
5. Yakooba J, Jafria W, Shaikh H. Is there an association of giardiasis with betathalassemia minor? East J Med. 2010;15:128–31
