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A Case of Idiopathic Interstitial Pneumonia in Childhood  

Lee, Su-Jin (Department of Pediatrics, College of Medicine, Hallym University)
Shin, Eon-Woo (Department of Pediatrics, College of Medicine, Hallym University)
Park, Eun-Young (Department of Pediatrics, College of Medicine, Hallym University)
Oh, Phil-Soo (Department of Pediatrics, College of Medicine, Hallym University)
Lee, Kon-Hee (Department of Pediatrics, College of Medicine, Hallym University)
Kim, Kwang-Nam (Department of Pediatrics, College of Medicine, Hallym University)
Shin, Ho-Seung (Department of Thoracic and Cardiovascular Surgery, College of Medicine, Hallym University)
Lee, Il-Seung (Department of Radiology, College of Medicine, Hallym University)
Publication Information
Clinical and Experimental Pediatrics / v.48, no.3, 2005 , pp. 327-332 More about this Journal
Abstract
Interstitial lung disease refers to a group of pulmonary disorders characterized by inflammation of the interstitium, derangements and loss of alveolar capillary units leading to disruption of alveolar gas exchange, which induces symptoms of restrictive lung disease. Cases of interstitial pneumonia in children are uncommon and mostly have unknown causes. We have experienced an 8-year old boy who had symptoms of cyanosis, dry cough, dyspnea and abrupt weight loss. He had not been exposed to organic dusts, allergens or any other systemic disease infections. Chest radiology showed diffuse ground glass opacity in both lung fields. High resolution computed tomography(HRCT) showed multiple small patchy areas of consolidation with an underlying ground glass appearance in both lungs. The pathologic findings of lung biopsy tissue showed patchy areas of interstitial fibrosis, alveolar obliteration and nodular fibrotic areas, strongly suggesting interstitial pneumonia. No specific finding of viral inclusion or any other evidence of infection was found under electromicroscopy. We used peak flow meters to compare functional improvement. Forced expiratory volume in one second ($FEV_1$) was decreased to 25 percent of predicted value. The boy was given treatment with prednisone and showed improvements in HRCT findings after two months. He was able to tolerate easy exercise in school and showed clinical improvements after one year of follow up.
Keywords
Interstitial pneumonia; Childhood;
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1 Howenstine MS. Interstitial lung diseases. Mclntosh K. In : Behrman RE, Kliegman RM, Jenson HB, editors. Nelson textbook of pediatrics. 17th ed. Philadelphia : WB Saunders Co, 2003:1451-3
2 Katzenstein AA, Myers JL. Nonspecific interstitial pneumonia and the other idiopathic interstitial pneumonias : classification and diagnostic criteria. Am J Surg Pathol 2000;24:1-3   DOI   ScienceOn
3 Fan LL, Mullen AL, Brugman SM, Inscore SC, Parks DP, White CW. Clinical spectrum of chronic interstitial lung disease in children. J Pediatr 1992;121:867-72   DOI   PUBMED
4 Katzenstein AA, Myers JL. Idiopathic pulmonary fibrosis. Respir Crit Care Med 1998;157:1301-15   DOI   ScienceOn
5 Katzenstein AA, Myers JL. Idiopathic pulmonary fibrosis. Respir Crit Care Med 1998;157:1301-15   DOI   ScienceOn
6 American Thoracic Society/European Respiratory Society International Consensus Statement. Idiopathic pulmonary fibrosis : diagnosis and treatment. Am J Respir Crit Care Med 2000;161:646-64   DOI   ScienceOn
7 Cook DN, Brass DM, Schwartz DA. A matrix for new ideas in pulmonary fibrosis. Am J Respir Cell Mol Biol 2002;27:122-4   DOI   ScienceOn
8 Langston C, Fan LL. The spectrum of interstitial lung disease in childhood. Pediatr Pulmonol 2001;(23 Suppl):70-1
9 Toews GB. Interstitial lung disease. In : Goldman L, Bennett JC, editors. Cecil textbook of medicine. 21th ed. Philadelphia : WB Saunders Co, 2000:409-15
10 Kim TW, Lym DH, Kim JH, Son BK, Han HS, Shin YK. A case of nonspecific interstitial pneumonia in a child. J Korean Pediatr Soc 2002;45:529-34
11 Kyung SY, Hahn HS, Song SH, Hwang JK, Lim YH, An CH, et al. The relationship of serum angiotensin converting enzyme(ACE), angiotensin II and clinical markers in the idiopathic interstitial pneumonia. Tuberc Respir Dis 2002;52:506-18
12 King TE. Interstitial lung diseases. In : Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison's principles of internal medicine. 15th ed. New York : McGraw-Hill Co, 2001:1499-505
13 Chung JH, Ha SJ, Kim BS, Hong SJ. Clinical spectrum and lung pathology in children with interstitial lung disease. J Korean Pediatr Soc 2002;45:79-87
14 Kim YS, Myung NH, Park JS, Jee YK, Lee KY. The correlation of TUNEL apoptotic index with clinicoradiologicopathologic scores in interstitial lung disease. Tuberc Respir Dis 2002;53:136-47
15 Barbato A, Panizzolo C, Cracco A, Blic J, Dinwiddie R, Zach M. Interstitial lung disease in children : a multicentre survey on diagnostic approach. Eur Respir J 2000;16:509-13   DOI   ScienceOn
16 Travis WD, Matsui K, Moss J, Ferrans VJ. Idiopathic nonspecific interstitial pneumonia : prognostic significance of cellular and fibrosing patterns. Am J Surg Pathol 2000;24:19-33   DOI   ScienceOn
17 Crystal RG, Bitterman PB, Mossman B, Schwarz MI, Sheppard D, Almasy L, et al. Future research directions in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2002;166:236-46   DOI   ScienceOn
18 Demedts M, Wells AU, Costabel U, Hubbard R, Cullinan P, Slabbynck H, et al. Interstitial lung diseases : an epidemiological overview. Eur Respir J Suppl 2001;32:2S-16S
19 Park J, Kitaichi M, Yum HK, Shim TS, Lim CM, Lee SD, et al. Clinical course of usual interstitial pneumonia. Tuberc Respir Dis 2000;49:601-13
20 Oh YG, Kim SH, Kim MR, Park BK, Youn HS, Yum MK. Two cases of idiopathic pulmonary fibrosis. J Korean Pediatr Soc 1992;35:122-8
21 Fan LL, Langston C. Chronic interstitial lung disease in children. Pediatr Pulmonol 1993;16:184-96   DOI   ScienceOn
22 Ziesche R, Hofbauer E, Wittmann K, Petkov V, Block LH. A preliminary study of long-term treatment with interferon $gamma-1{\beta}$ and low dose prednisolone in patients with idiopathic pulmonary fibrosis. N Engl J Med 1999;241:1264-9
23 Liebow AA. Definition and classification of interstitial pneumonias in human pathology. Prog Respir Res 1975;8:1-31