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Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Childhood interstitial lung disease in Turkey: first data from the national registry
Halime Nayır-Büyükşahin1,2, Nagehan Emiralioğlu3, Ayşe Ayzıt Kılınç4
1Division of Pulmonology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey. hnayirbuyuksahin@gmail.com.
Insights
The first results from the childhood interstitial lung diseases (chILD) registry in Turkey reveal key differences in presentation and treatment between infant-onset and all-age diffuse parenchymal lung diseases. Findings highlight the need to consider nutrition, especially in infants with chILD.
Area of Science:
- Pediatric Pulmonology
- Rare Diseases
- Medical Registries
Background:
- Childhood interstitial lung diseases (chILD) are a heterogeneous group of rare disorders that pose diagnostic and management challenges.
- Establishing national registries is crucial for understanding the epidemiology and clinical characteristics of chILD.
- The chILD Turkey registry (chILD-TR) was created to improve awareness, diagnosis, and treatment standards.
Purpose of the Study:
- To present the initial findings from the chILD-TR, a prospective cohort study.
- To analyze the demographic, clinical, radiologic, and treatment characteristics of registered chILD patients in Turkey.
- To compare clinical features between infants with chILD and those diagnosed at all ages.
Main Methods:
- Prospective cohort study utilizing a data-entry software system.
- Inclusion of 416 patients from 19 centers, with 370 analyzed after exclusions.
- Comparison of clinical characteristics between two groups: Group 1 (infancy-onset DPLD) and Group 2 (all-age DPLD).
Main Results:
- The median age of diagnosis was 6.05 years. Group 1 comprised 21.8% and Group 2 comprised 78.1% of patients.
- Group 1 showed significantly lower weight z-scores and more frequent ground-glass opacities on CT scans.
- Group 2 had more frequent nodular opacities, bronchiectasis, mosaic perfusion, and mediastinal lymphadenopathy; oral steroid use was higher in Group 2.
Conclusions:
- The chILD-TR provides valuable insights into the frequency, types, and treatment of chILD in Turkey, identifying diagnostic and management challenges.
- Significant differences exist in clinical presentation and radiologic findings between infant-onset and later-onset chILD.
- Nutritional status is a critical consideration for all chILD patients, particularly those with infancy-onset disease.
Abstract:
The childhood interstitial lung diseases (chILD) Turkey registry (chILD-TR) was established in November 2021 to increase awareness of disease, and in collaboration with the centers to improve the diagnostic and treatment standards. Here, the first results of the chILD registry system were presented. In this prospective cohort study, data were collected using a data-entry software system. The demographic characteristics, clinical, laboratory, radiologic findings, diagnoses, and treatment characteristics of the patients were evaluated. Clinical characteristics were compared between two main chILD groups ((A) diffuse parenchymal lung diseases (DPLD) disorders manifesting primarily in infancy [group1] and (B) DPLD disorders occurring at all ages [group 2]). There were 416 patients registered from 19 centers. Forty-six patients were excluded due to missing information. The median age of diagnosis of the patients was 6.05 (1.3-11.6) years. Across the study population (n = 370), 81 (21.8%) were in group 1, and 289 (78.1%) were in group 2. The median weight z-score was significantly lower in group 1 (- 2.0 [- 3.36 to - 0.81]) than in group 2 (- 0.80 [- 1.7 to 0.20]) (p < 0.001). When we compared the groups according to chest CT findings, ground-glass opacities were significantly more common in group 1, and nodular opacities, bronchiectasis, mosaic perfusion, and mediastinal lymphadenopathy were significantly more common in group 2. Out of the overall study population, 67.8% were undergoing some form of treatment. The use of oral steroids was significantly higher in group 2 than in group 1 (40.6% vs. 23.3%, respectively; p = 0.040). Conclusion: This study showed that national registry allowed to obtain information about the frequency, types, and treatment methods of chILD in Turkey and helped to see the difficulties in the diagnosis and management of these patients. What is Known: • Childhood interstitial lung diseases comprise many diverse entities which are challenging to diagnose and manage. What is New: • This study showed that national registry allowed to obtain information about the frequency, types and treatment methods of chILD in Turkey and helped to see the difficulties in the diagnosis and management of these patients. Also, our findings reveal that nutrition should be considered in all patients with chILD, especially in A-DPLD disorders manifesting primarily in infancy.
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