Desquamative interstitial pneumonia in a child related to cigarette smoke

Pediatr Pulmonol. 2014 Mar;49(3):E56-8. doi: 10.1002/ppul.22812. Epub 2013 Jun 17.

Abstract

An 8-year-old white male was referred to our clinic for a 1-year history of decreased appetite and no weight gain. His entire workup failed to demonstrate cystic fibrosis, or any infectious or immune-related diseases. Chest imaging and clinical picture suggested parenchymal lung disease. Histopathology examination of the video-assisted thoracoscopic biopsy of his lungs showed a desquamative interstitial pneumonia (DIP)-like pattern that resembled that of adult smokers with the same disease. Genes for surfactant proteins B and C and the transporter ABCA3 were all negative. Furthermore, lack of any genetic disorder for surfactant proteins, along with his history of heavy exposure to 10 pack-years of indoor secondhand smoke suggests that this child's DIP is due to secondhand cigarette exposure. He had nearly complete resolution of his symptoms after a year of treatments with pulse steroid and hydroxycholoroquine. To the best of our knowledge this is the first case of cigarette smoke-related DIP reported in a child.

Keywords: child health; cigarette smoke; lung disease; pneumonitis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Child
  • Humans
  • Hydroxychloroquine / therapeutic use
  • Lung / diagnostic imaging
  • Lung / pathology*
  • Lung Diseases, Interstitial / diagnosis
  • Lung Diseases, Interstitial / drug therapy
  • Lung Diseases, Interstitial / etiology*
  • Male
  • Methylprednisolone / therapeutic use
  • Thoracic Surgery, Video-Assisted
  • Tobacco Smoke Pollution / adverse effects*
  • Tomography, X-Ray Computed

Substances

  • Anti-Inflammatory Agents
  • Tobacco Smoke Pollution
  • Hydroxychloroquine
  • Methylprednisolone