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Chronic obstructive pulmonary disease in children
S K Kabra1, R Lodha, T Singhal
1Department of Pediatrics, All India Institute of Medical Sciences, New Delhi. skkabra@medinst.ernet.in
Insights
Pediatric chronic obstructive pulmonary disease (COPD) requires thorough investigation for causes like asthma or environmental factors. Treatment focuses on environmental control, bronchodilators, and chest physiotherapy for persistent cough.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
Background:
- Chronic obstructive pulmonary disease (COPD) lacks a clear definition in pediatric populations.
- Children with chronic cough and wheezing present a diagnostic challenge.
Purpose of the Study:
- To outline the diagnostic approach for children with symptoms suggestive of COPD.
- To identify potential underlying causes and contributing environmental factors.
- To suggest therapeutic strategies for managing chronic productive cough in children without a specific diagnosis.
Main Methods:
- Review of differential diagnoses for chronic cough and wheezing in children.
- Emphasis on identifying specific conditions such as asthma, cystic fibrosis, and immune deficiencies.
- Consideration of environmental factors including passive smoking and air pollution.
Main Results:
- A systematic investigation is crucial when pediatric COPD is suspected.
- Asthma, recurrent aspiration, chronic infections, cystic fibrosis, and immune deficiencies are key differential diagnoses.
- Environmental factors play a significant role when specific etiologies are not found.
Conclusions:
- Early and comprehensive evaluation is essential for diagnosing pediatric COPD.
- Management involves addressing identified causes and environmental triggers.
- Bronchodilators and chest physiotherapy are important therapeutic options for symptomatic relief.
Abstract:
Chronic obstructive pulmonary disease is not a well defined entity in children. A child presenting with chronic cough and wheezing should be investigated for asthma, recurrent aspiration airway compressions, chronic infection, cystic fibrosis and immune deficiency. If a specific cause is not identified; search should be made for environmental factors such as passive smoking, air pollution and irritants. The therapeutic option for patients with chronic productive cough without specific etiology include control of environmental factors, bronchodilators and chest physiotherapy.