Pulmonary complications of endocrine and metabolic disorders
Carlos E Milla1, Jacquelyn Zirbes
1Center for Excellence in Pulmonary Biology, Stanford University Medical School, Palo Alto, CA, USA. cmilla@stanford.edu
Insights
Endocrine and metabolic diseases in children can cause serious respiratory issues, including infections and breathing problems. Early diagnosis and distinguishing these from conditions like cystic fibrosis are crucial for proper management.
Area of Science:
- Pediatric Endocrinology
- Pulmonology
- Metabolic Disorders
Background:
- Endocrine and metabolic diseases present diverse respiratory complications in children.
- Pulmonary manifestations range from infections to edema and airway obstruction.
Purpose of the Study:
- To review the significant respiratory manifestations of endocrine and metabolic diseases in pediatric patients.
- To highlight diagnostic challenges and key features of these conditions.
Main Methods:
- Literature review of endocrine and metabolic disorders affecting the pediatric respiratory system.
- Analysis of clinical presentations, diagnostic criteria, and management considerations.
Main Results:
- Diabetes mellitus is associated with common pulmonary infections and edema.
- Pseudohypoaldosteronism type 1 mimics cystic fibrosis (CF) but is differentiated by electrolyte and hormone levels.
- Thyroid dysfunction impacts lung function and respiratory drive.
- Hypoparathyroidism complications include laryngospasm.
- Ovarian tumors can cause pleural effusions.
- Metabolic storage disorders affect the respiratory system due to enzymatic deficiencies.
Conclusions:
- Respiratory symptoms in children warrant evaluation for underlying endocrine and metabolic disorders.
- Accurate diagnosis requires specific laboratory tests and genetic analysis when needed.
- Management of these conditions is vital for respiratory health in affected children.
Abstract:
There are many important respiratory manifestations of endocrine and metabolic diseases in children. Acute and chronic pulmonary infections are the most common respiratory abnormalities in patients with diabetes mellitus, although cardiogenic and non-cardiogenic pulmonary oedema are also possible. Pseudohypoaldosteronism type 1 may be indistinguishable from cystic fibrosis (CF) unless serum aldosterone, plasma renin activity, and urinary electrolytes are measured and mutation analysis rules out CF. Hypo- and hyperthyroidism may alter lung function and affect the central respiratory drive. The thyroid hormone plays an essential role in lung development, surfactant synthesis, and lung defence. Complications of hypoparathyroidism are largely due to hypocalcaemia. Laryngospasm can lead to stridor and airway obstruction. Ovarian tumours, benign or malignant, may present with unilateral or bilateral pleural effusions. Metabolic storage disorders, primarily as a consequence of lysosomal dysfunction from enzymatic deficiencies, constitute a diverse group of rare conditions that can have profound effects on the respiratory system.
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