Children's Interstitial and Diffuse Lung Diseases (ChILD) in 2020.

Area of Science:

• Pediatric Pulmonology
• Rare Diseases
• Respiratory Medicine

Background:

• Children's interstitial lung diseases (chILD) encompass a rare, heterogeneous group of diffuse lung disorders affecting infants and young children.
• These conditions present with varied clinical manifestations, often including nonspecific respiratory symptoms like dyspnea, tachypnea, cough, wheezing, and exercise intolerance.
• Specific chILD entities in children under two years include developmental disorders, growth abnormalities, neuroendocrine cell hyperplasia of infancy, pulmonary interstitial glycogenosis, and surfactant protein disorders.

Purpose of the Study:

• To provide an overview of children's interstitial lung diseases (chILD).
• To highlight the diagnostic approaches and treatment strategies for chILD.
• To emphasize the importance of physician familiarity with chILD for prompt diagnosis and management.

Main Methods:

• Review of clinical manifestations, diagnostic tools, and treatment options for chILD.
• Emphasis on the role of high-resolution computed tomography (HRCT) and genetic testing in diagnosis.
• Inclusion of laryngotracheal-bronchoscopy and lung biopsy for uncertain cases.

Main Results:

• chILD presents with a wide spectrum of symptoms, from asymptomatic to severe onset, commonly involving nonspecific respiratory signs.
• High-resolution computed tomography (HRCT) and genetic testing are central to the diagnostic process.
• Current pharmacological treatments are largely empiric, utilizing anti-inflammatory and immunomodulatory agents such as corticosteroids, hydroxychloroquine, and azithromycin.

Conclusions:

• Pediatric pulmonologists require familiarity with chILD to ensure timely diagnosis and effective patient management.
• Despite their rarity, prompt recognition and appropriate treatment of chILD are essential for improving patient outcomes.
• The diagnostic pathway involves a combination of imaging, genetic analysis, and, when necessary, invasive procedures like bronchoscopy and biopsy.