Categorizing diffuse parenchymal lung disease in children
نویسندگان
چکیده
BACKGROUND Aim of this study was to verify a systematic and practical categorization system that allows dynamic classification of pediatric DPLD irrespective of completeness of patient data. METHODS The study was based on 2322 children submitted to the kids-lung-register between 1997 and 2012. Of these children 791 were assigned to 12 DPLD categories, more than 2/3 belonged to categories manifesting primarily in infancy. The work-flow of the pediatric DPLD categorization system included (i) the generation of a final working diagnosis, decision on the presence or absence of (ii) DPLD and (iii) a systemic or lung only condition, and (iv) the allocation to a category and subcategory. The validity and inter-observer dependency of this workflow was re-tested using a systematic sample of 100 cases. RESULTS Two blinded raters allocated more than 80% of the re-categorized cases identically. Non-identical allocation was due to lack of appreciation of all available details, insufficient knowledge of the classification rules by the raters, incomplete patient data, and shortcomings of the classification system itself. CONCLUSIONS This study provides a suitable workflow and hand-on rules for the categorization of pediatric DPLD. Potential pitfalls were identified and a foundation was laid for the development of consensus-based, international categorization guidelines.
منابع مشابه
THE DIAGNOSTIC YIELD OF TRANSBRONCHIAL LUNG BIOPSY IN DIFFUSE INFILTRATIVE PULMONARY DISEASES BY PLAIN CUP FORCEPS. A STUDY OF 54 CASES IN IRAN
The technique of transbronchial lung biopsy (TBLB) has expanded the diagnostic yield of bronchoscopy . In this article we are presenting 54 patients with diffuse pulmonary parenchymal involvement who underwent this procedure during six years between June 1980 and December 1989. The diagnostic yield of this technique in diffuse pulmonary parenchymal disease is great and was 66 percent exclu...
متن کاملOpen lung biopsy for diffuse parenchymal lung disease in children.
An open lung biopsy was performed in 12 children with diffuse parenchymal lung disease. A definitive histopathological diagnosis was obtained from all procedures but determined treatment options in only 10 children (83%). Three (25%) children were ventilated for respiratory failure prior to the procedure. Four (44%) of the other 9 children required ventilatory support after the procedure. Three...
متن کاملترانس برونکیال بیوپسی ریه بدون هدایت فلوروسکوپی بیمارستان امام، 1378 1
Background: Transbronchial lung biopsy (TBLB) is an attractive alternative to open lung biopsy as an initial diagnostic procedure for patients with diffuse parenchymal disease or localized densities beyond direct endoscopic vision. TBLB can be carried out safely without fluoroscopy in patients with diffuse lung disease. Since in our bronchoscopic department fluoroscopy is not available, we plan...
متن کاملترانس برونکیال بیوپسی ریه بدون هدایت فلوروسکوپی بیمارستان امام، 1378
Background: Transbronchial lung biopsy (TBLB) is an attractive alternative to open lung biopsy as an initial diagnostic procedure for patients with diffuse parenchymal disease or localized densities beyond direct endoscopic vision. TBLB can be carried out safely without fluoroscopy in patients with diffuse lung disease. Since in our bronchoscopic department fluoroscopy is not available, we plan...
متن کاملAlpha- 1 Antitrypsin Deficiency in Children: Pulmonary Involvement
Introduction: α1-antitrypsin deficiency (α1-ATD) is one of the most common genetic disorders in white race, a usual cause of liver disease in children, and hepatopulmonary involvement in children and adult. The aim of this case description is presenting a child with early lung disease without liver parenchymal disorder. Case presentation: We describe a 13 year old boy because of exertional dysp...
متن کامل