Pediatric Interstitial Lung Disease-Approach to Diagnosis and ManagementReview
Abstract:
Interstitial lung disease (ILD) consists of a diverse group of disorders that involve the pulmonary parenchyma and interfere with gas exchange. “Diffuse parenchyma lung disease" or “diffuse lung disease”. ILD is rare in childhood. • Children with ILD may present with respiratory failure, or with more indolent or chronic symptoms including tachypnea, hypoxemia, retractions, cough, exercise intolerance, failure to thrive, and gastro esophageal reflux. • ILD should be considered in any neonate who presents with unexplained respiratory failure, or in infants and children with a normal birth history who present with persistent tachypnea, crackles, hypoxemia, chronic cough, or clubbing of the digits.ILD should also be considered in late preterm or preterm infants who present with chronic lung disease out of proportion to the degree of prematurity or other known co morbidities • Diagnostic studies in children with suspected interstitial lung disease is to exclude more common causes of chronic respiratory symptoms: Cough, wheeze and dyspnoea Chest deformity, stunting and failure to thrive. clubbing, halitosis sputum production, cyanosis, or cor-pulmonale. Chest X-Ray finding mainly Interstitial infiltrate (Discrete, Linear, Nodular or reticulonodular shadows < 2mm) in diffuse distribution in both lung. In advanced stage fibrosis is extensive & lungs are shrunken & reduced in volume. normal CXR doesn’t exclude ILD. Spirometry –In ILD there is restrictive defect, tidal volumes – small, vital capacity / TLC – Reduced. HRCT of chest: Ground glass opacity, Reticulonodular Shadowing Honey comb lung (small, uniform sized, cystic spaces representing patent bronchioles). It provides quantitative assessment of pulmonary fibrosis.
