1829 Severe Forms of Osteogenesis Imper.Fecta (OI) In Infants and the Role of Respiratory Syncitial Virus (RSV) Immunoprophylaxis with Palivizumab

Abstract

Background and Aims Respiratory illnesses could be serious, even life threatening among infants with severe forms of osteogenesis imperfecta (OI). Respiratory syncitial virus (RSV) bronchiolitis could deteriorate the respiratory status of infants with severe OI increasing length of stay (LOS) and often needing paediatric high dependency unit (PHDU) or paediatric intensive care unit (PICU) care. Immunoprophylaxis using Palivizumab - monoclonal antibody to RSV F protein could prevent RSV bronchiolitis for severe OI infants. We aimed to audit our local practice and national data. Methods We conducted a retrospective chart review of infants with severe OI in the Mid-West of Ireland from 2005 to 2010, all of whom received Palivizumab in addition to the standard care for OI with early bisphosphonates. From national computerised Hospital In-Patient Enquiry (HIPE) data information on all infants in Ireland with OI admission and RSV positive bronchiolitis was tabulated. LOS and bed days use nationally were determined. Information of immunoprophylaxis for national OI cohort was obtained from the national provider of Palivizumab. Hospital audit committee approval was sought. Results No infant in the Mid-West of Ireland with severe OI who have received Palivizumab developed RSV bronchiolitis Nationally 17% of non-prophylaxed infants with OI developed RSV positive bronchiolitis among the 121 admissions. Increased LOS, bed days consumption and PICU admission were observed among those with dual pathology of severe OI and RSV infection. We could not establish statistical significance for observations. Conclusion Infants with severe forms of Osteogenesis Imperfecta seems to benefit from RSV immunoprophylaxis with Palivizumab.