Clinical profile and outcome of Childhood Interstitial Lung Disease (chILD) Syndrome in a tertiary pediatric hospital: a 10-year review (2013-2022)
Juan Carlos D. Moreno | Jenni Rose D. Dimacali
Discipline: medicine by specialism
Abstract:
OBJECTIVE: This study described childhood interstitial lung disease profiles at the Philippine Children‘s Medical Center (2013-2022).
MATERIALS AND METHODS: A retrospective chart review at PCMC analyzed pediatric interstitial lung disease cases (Jan 2013-Dec 2022). Included were patients aged 0-18 with childhood interstitial lung disease. Excluded were those with specific conditions. Data included clinical course, tests, therapeutic management, and short-term outcomes based on a previous study.
RESULTS: Twenty-three patients were included in this study. Most (52.17%) were diagnosed between 2013-2017, and were within the ages of 0-2 years. Majority of patients had normal nutritional status (52.17%). Common clinical presentation on admission included breathing difficulties, with chest retractions, crackles, and hypoxemia. Few had a family history of chronic lung disease. Comorbidities included pulmonary hypertension (30.43%) and pulmonary tuberculosis (21.74%). Chest radiography revealed infiltrates in all cases, and HRCT scans showed ground glass opacities in 82.61%. Prednisone was the primary treatment (86.96%). Lung biopsy results (43.48%) were mostly unclassified or nondiagnostic, with lymphoid interstitial pneumonia as the predominant diagnosis (20%). Improvement of signs and symptoms was seen in 39.13% of cases, whereas death occurred in 21.74%. Furthermore, the outcome remained undetermined in as much as 34.78% of cases due to inadequate follow-up.
CONCLUSION: This retrospective study emphasizes chILD's prevalence in infants under 2 years, with male predominance. Nutritional variations underscore the need for supplementation. Various common signs include crackles, retractions, and hypoxemia, with breathing difficulty as a frequent symptom. The diagnostic process involves imaging and ancillary tests, advocating a systematic approach with noninvasive methods like CXR and HRCT, reserving lung biopsy for inconclusive cases. Corticosteroids, whether used alone or in combination, prove beneficial in managing chILD by suppressing inflammation.
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