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. 2022 Oct;57(10):2344-2355.
doi: 10.1002/ppul.26038. Epub 2022 Jun 25.

Clinical radiological and pathological staging of children with hypersensitivity pneumonitis

Beste Ozsezen  1 , H Nursun Özcan  2 , Nagehan Emiralioglu  1 , Ece Ocak  3 , Dilber Ademhan Tural  1 , Birce Sunman  1 , Halime Nayir Buyuksahin  1 , İsmail Guzelkas  1 , Güzin Cinel  3 , Diclehan Orhan  4 , Ebru Yalçın  1 , Deniz Doğru  1 , Uğur Özçelik  1 , Nural Kiper  1
Affiliations

Clinical radiological and pathological staging of children with hypersensitivity pneumonitis

Beste Ozsezen et al. Pediatr Pulmonol. 2022 Oct.

Abstract

Objective: Hypersensitivity pneumonitis (HP) is rare in the pediatric population. To date, there are no studies defining a correlation between clinical, radiological, and pathological findings in children with HP. The objective of this study is to define the clinical, and radiological characteristics and prognosis of childhood HP and to examine the clinical, radiological, and pathological correlation between HP stages.

Methods: Patients with suspected HP and followed at two tertiary care hospitals between 2000 and 2020 were retrospectively evaluated. Computed tomography (CT) of the chest of patients was evaluated by a single radiologist. The interagreement between clinical and radiological severity of the patients was calculated with the κ test.

Results: Fourteen children with suspected HP were identified. The results of 10 patients with the definitive diagnosis were as follows: one patient (10%) had acute, five patients (50%) had subacute, and four patients (40%) had chronic HP. The most prominent findings in chest CT were hilar, or hilar and subcarinal lymphadenopathy (80%), centrilobular nodules (60%), patchy or diffuse ground-glass opacities (50%), and cysts (50%). The interagreement between clinical and radiological severity of the patients was 100% (approximate significance: 0.003). The diagnosis of four patients with suspected HP who were unresponsive to standardized medical treatments or developed multisystem involvement was diagnosed with other diseases. One patient (10%) with definitive chronic HP died due to respiratory failure during follow up.

Conclusion: Similar to adult HP, the prognosis is worse in children with existing fibrotic equivalents in chest CT. Patients who are not responding to standard medical treatments or develop multisystem involvement should be evaluated for other lung diseases.

Keywords: FARS; children's interstitial lung disease (chILD); computed tomography; hypersensitivity pneumonitis; pulmonary veno-occlusive disease.

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References

REFERENCES

    1. Chiba S, Tsuchiya K, Akashi T, et al. Chronic hypersensitivity pneumonitis with a usual interstitial pneumonia-like pattern: correlation between histopathologic and clinical findings. Chest. 2016;149(6):1473-1481.
    1. Griese M, Haug M, Hartl D, et al. Hypersensitivity pneumonitis: lessons for diagnosis and treatment of a rare entity in children. Orphanet J Rare Dis. 2013;8:121.
    1. Lacasse Y, Cormier Y. Hypersensitivity pneumonitis. Orphanet J Rare Dis. 2006;1:25.
    1. Nathan N, Taam RA, Epaud R, et al. A national Internet-linked based database for pediatric interstitial lung diseases: the French network. Orphanet J Rare Dis. 2012;7:40.
    1. Cinel G, Kiper N, Orhan D, et al. Childhood diffuse parenchymal lung diseases: we need a new classification. Clin Respir J. 2020;14(2):102-108.

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