Medicine:Childhood interstitial lung disease

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Short description: Family of rare chronic and complex disorders that affect the lungs of children
childhood interstitial lung disease
Other namesChILD
SpecialtyPulmonology

Childhood interstitial lung disease, sometimes abbreviated as ChILD, is a family of rare chronic and complex disorders that affect the lungs of children.[1] In the lungs, these disorders affect the interstitium, which is the space around the alveoli. The alveoli are the air sacs of the lungs.[2] For these disorders, the alveoli are typically impaired by inflammatory and fibrotic changes which can lead to dyspnea, diffuse infiltrates on chest radiographs, and abnormal pulmonary function tests.[3]

Not all types of interstitial lung disease that occur in adults occur also in children, and vice versa.[4][5] The group of disorders is heterogenous, and there are different definitions of what exactly should be classed as a ChILD disorder.[1]

Childhood interstitial lung disease is a serious condition, with high morbidity and mortality.[6][4] People with ChILD are at a higher risk of developing pulmonary hypertension, and development of pulmonary hypertension is associated with poor survival rates.[6]

Classification

Many conditions are included in this group of diseases. They have been categorized into three groups:[7]

  • disorders of infancy, including lung problems caused by developmental disorders, growth abnormalities, and surfactant-related disorders;
  • other categories that aren't specific to infancy, such as problems related to infections and immune disorders; and
  • unclassifiable disorders

Diagnosis

Obtaining images of sufficient quality is more difficult than in adults. Imaging may or may not be sufficient for diagnosis.[4]

Diagnostic methods include echocardiography, computed tomography, pulmonary function testing, bronchoscopy, genetic testing and biopsy.[5]

Treatment

Although there is no cure for ChILD, common treatments include oxygen therapy, bronchodilators, extra nutrition, and corticosteroid medications. In severe ChILD cases, a lung transplant may prove effective. [8]

References

  1. 1.0 1.1 Hime, Neil J.; Zurynski, Yvonne; Fitzgerald, Dominic; Selvadurai, Hiran; Phu, Amy; Deverell, Marie; Elliott, Elizabeth J.; Jaffe, Adam (December 24, 2015). "Childhood interstitial lung disease: A systematic review". Pediatric Pulmonology 50 (12): 1383–1392. doi:10.1002/ppul.23183. PMID 25931270. 
  2. Moore, Keith (2018). Clinically oriented anatomy. Wolters Kluwer. pp. 336. ISBN 9781496347213. 
  3. Clement, Annick; Nathan, Nadia; Epaud, Ralph; Fauroux, Brigitte; Corvol, Harriet (August 20, 2010). "Interstitial lung diseases in children". Orphanet Journal of Rare Diseases 5 (22): 22. doi:10.1186/1750-1172-5-22. PMID 20727133. 
  4. 4.0 4.1 4.2 Guillerman, R. Paul (March 24, 2010). "Imaging of Childhood Interstitial Lung Disease". Pediatric Allergy, Immunology, and Pulmonology 23 (1): 43–68. doi:10.1089/ped.2010.0010. PMID 22332031. 
  5. 5.0 5.1 Kurland, G.; Deterding, R. R.; Hagood, J. S.; Young, L. R.; Brody, A. S.; Castile, R. G.; Dell, S.; Fan, L. L. et al. (2013). "An official American Thoracic Society clinical practice guideline: classification, evaluation, and management of childhood interstitial lung diseas... - PubMed - NCBI". American Journal of Respiratory and Critical Care Medicine 188 (3): 376–94. doi:10.1164/rccm.201305-0923ST. PMID 23905526. 
  6. 6.0 6.1 Bromley, Susan; Vizcaya, David (May 24, 2017). "Pulmonary hypertension in childhood interstitial lung disease: A systematic review of the literature". Pediatric Pulmonology 52 (5): 689–698. doi:10.1002/ppul.23632. PMID 27774750. 
  7. Cleveland, Robert H.; Lee, Edward Y. (2019-09-24) (in en). Imaging in Pediatric Pulmonology. Springer Nature. pp. 145–148. ISBN 978-3-030-23979-4. https://books.google.com/books?id=u7yxDwAAQBAJ&pg=PA145. 
  8. "Childhood Interstitial Lung Disease". https://www.nhlbi.nih.gov/health-topics/childhood-interstitial-lung-disease.