The Clinical Study For Etiology Of Diffuse Parenchymal Lung Disease/Interstitial Lung Disease In Children

OBJECTIVE: To explore the diagnostic procedure and distribution of the etiology, in addition to the contribution of clinical data to the etiologic diagnosis of diffuse parenchymal lung disease/interstitial lung disease in children. So as to improve the diagnosis of pediatric diffuse parenchymal lung disease/interstitial lung disease could be offered.METHODS: Twenty-seven patients from the First Affiliated Hospital of Guangxi Medical University with diffuse parenchymal lung disease/interstitial lung disease between April 2009 and March 2011 were included in the study. Diagnostic procedures were established by referring to the guidelines which were suggested for children by pediatric diffuse parenchymal lung disease/pediatric interstitial lung disease cooperative group. Collected cases according to the procedure, then registered and also regular followed-up of all cases. We could understand the constituent ratio of cause for local children with diffuse parenchymal lung disease/interstitial lung disease through the etiology analysis of all cases.RESULTS: 1. With the diagnostic procedures of the causes for diffuse parenchymal lung disease/interstitial lung disease raised by pediatric diffuse parenchymal lung disease/pediatric interstitial lung disease cooperative group, the definite causes were made in 24 cases (89% of the whole group), 2 cases only had suspected diagnosis (7%), 1 case (4%) of unknow reason. 2. The causes of pediatric diffuse parenchymal lung disease/interstitial lung disease in this study were: 16 cases (59%) with idiopathic pulmonary hemosiderosis (IPH), 3 cases (11%) with diffuse panbronchiolitis (DPB), 2 cases (7%) with bronchiolitis obliterans (BO), 1 case (4%) with juvenile rheumatoid arthritis-interstitial lung disease (JRA-ILD), 1 case (4%) with systemic sclerosis (SSc), 1 case (4%) with extrinsic allergic alveolitis (EAA), suggestive diagnoses included: acute interstitial pneumonia (AIP) in 1 (4%), nonspecific interstitial pneumonia (NSIP) in 1 (4%), and 1 case of unknow reason. 3. Medical history, clinical symptoms, chest X-ray and the effect of corticorstiroid treatment may provid the clue for diagnosis of diffuse parenchymal lung disease/interstitial lung disease in the certain extent. The children who had anemia or bleeding sputum suggested IPH; It was an important basis for diagnosis of IPH, that hemosiderin cells were founded in sputum,gastric juice,bronchoalveolar lavage fluid; sinusitis was a diagnosis basis for DPB. Detecting autoantibodies could assist the diagnosis of rheumatic diseases and interstitial lung disease; Forced expiratory volume in one second and forced mid-expiratory expiratory flow were considered to be sensitive diagnostic indicators of BO. 4. Chest high-resolution CT played an important role in the diagnosis for diffuse parenchymal lung disease/interstitial lung disease.CONCLUSION: 1. The top third causes for children with diffuse parenchymal lung disease/interstitial lung disease in this study were IPH, DPB and BO. 2. The diagnosis of diffuse parenchymal lung disease/interstitial lung disease in children must combine with the medical history, clinical symptoms, signs, pulmonary function tests and so on, chest CT especially high-resolution CT played an important role in the diagnosis of diffuse parenchymal lung disease/interstitial lung disease . We should consider invasive inspection if the cause was not clear. 3. The diagnostic procedures could make diagnosis for most of the cases with diffuse parenchymal lung disease/interstitial lung disease in this study.