For adults who cough up 'tree branches,' Philly docs have answer

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One of the rubbery "casts" that patients with plastic bronchitis cough up periodically. They occur when lymphatic fluid leaks into the bronchial tubes.

If you are prone to coughing up an odd, cheese-like substance in the shape of tree branches, a team of Philadelphia physicians may have the answer, according to their new study.

Earlier this year, the team at Children's Hospital of Philadelphia and the University of Pennsylvania reported success in treating children with this rare condition, using a procedure called lymphatic embolization.

In the new study, the physicians say it works in adults, too, blocking abnormal flow of lymphatic fluid into the lungs.

The whitish fluid hardens into rubbery casts of the airways, hence the alarming, branch-like appearance of the material that patients cough up periodically.

The minimally invasive treatment involves using catheters to insert tiny metal coils and medical-grade glue into the lymphatic ducts, thereby preventing the leakage of lymph fluid into the lungs.

Five out of six adults who underwent this treatment experienced "immediate and complete" relief from symptoms, the authors wrote in Annals of the American Thoracic Society.

The sixth patient reported partial but significant improvement.

In the earlier study on children, the condition was an apparent side effect of surgery to correct congential heart defects.

The cause of the symptoms in the adults, on the other hand, was unknown.


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