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[Clinical study on interstitial lung disease in children of China]
Hui-zhong Chen1, ,
1Department of Respiratory Diseases, Children's Hospital Affiliated to Capital Institutte of Pediatrics, Chinese Medical Assocaition. chenhzcip@yahoo.com.cn
Insights
Pediatric interstitial lung disease (ILD) is diverse, with bronchiolitis obliterans (BO), idiopathic pulmonary hemosiderosis (IPH), and idiopathic interstitial pneumonia (IIP) being the most common diagnoses. This study analyzed 93 pediatric ILD cases, revealing 11 distinct conditions.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Pediatric Critical Care
Context:
- Interstitial lung disease (ILD) in children encompasses a wide spectrum of conditions.
- Understanding the specific etiological and diagnostic landscape of pediatric ILD is crucial for effective management.
- This study addresses the heterogeneity of pediatric ILD within a large cohort.
Purpose:
- To investigate the causes and diagnostic approaches for interstitial lung disease in children.
- To provide insights into the current management strategies for pediatric ILD.
- To characterize the clinical and radiological features of various pediatric ILD subtypes.
Summary:
- A retrospective analysis of 93 pediatric ILD cases from 11 hospitals in China was conducted.
- Diagnoses included bronchiolitis obliterans (BO), idiopathic pulmonary hemosiderosis (IPH), and idiopathic interstitial pneumonia (IIP) as the most frequent.
- High-resolution computed tomography (HRCT) revealed common findings such as ground-glass opacities and mosaic patterns.
Impact:
- This research highlights the diverse nature of pediatric ILD, emphasizing the need for specialized diagnostic tools and tailored treatment plans.
- The findings contribute to a better understanding of the prevalence and presentation of different ILD subtypes in children.
- This study provides valuable data for clinicians and researchers involved in pediatric respiratory medicine.
Objective:
Interstitial lung disease in children represents a heterogeneous group of disorders of both known and unknown causes. This study aimed to understand better the causes of the disease in children and to provide information on the current approach to diagnosis and management of the disease.
Method:
Through the Pediatric Diffuse Parenchymal Lung Disease/Pediatric Interstitial Lung Disease Cooperative Group of China, data of 93 cases of interstitial lung disease of children from 11 hospitals were collected with the same questionnaire in 2009. Respiratory tract secretions were obtained for bacterial culture. Respiratory virus antigen examination, mycoplasma antibody, EB virus, cytomegalovirus, and herpes simplex viruses antibody detection were performed. Cells in the sputum, gastric juice and bronchoalveolar lavage fluid (BALF) were tested for hemosiderin. The CT or high resolution CT (HRCT) of the lung and blood-gas analysis were also performed. Fourteen cases underwent lung biopsy and 25 cases underwent bronchomicrocopy. Data were then pooled and discussed through a series of meetings.
Result:
Fifty-three cases were male, 40 were female and their age ranged from 8 months to 14 years. Thirty-nine cases were diagnosed as bronchiolitis obliterans (BO); 39 as idiopathic pulmonary hemosiderosis (IPH); 7 as idiopathic interstitial pneumonia (IIP) of unknown causes, of whom 4 cases had non specific interstitial pneumonia, 1 case as acute interstitial pneumonia and 1 case as lymphocytic interstitial pneumonia, 1 case as idiopathic pulmonary fibrosis; 2 cases as secondary interstitial lung disease, one was secondary to SLE, one to human immunodeficiency virus (HIV) infection; 2 cases had hypersensitive pneumonitis; 2 cases had pulmonary alveolar proteinosis; 1 case had bronchiolitis obliterans organizing pneumonia; 1 case had lipoid pneumonia;1 case of diffuse panbronchiolitis; 1 case of microlithiasis alveolaris pulmonum. Forty two cases had cough, 24 of them also had tachypnea, 8 cases had clubbing. HRCT showed that 56 cases had groundglass-like opacification; 30 cases had mosaic appearance; 1 case had diffuse micronodular opacities, 1 case had diffuse reticulonodular opacities and cysts.
Conclusion:
Interstitial lung disease in children is a heterogeneous group of disorders. In this study diagnoses of 11 diseases were made, the top third diagnoses were BO, IPH and IIP, respectively.
