title: Desquamative interstitial pneumonia in a child related to cigarette smoke.
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.
authors.affiliation: Division of Allergy/Pulmonary, Department of Pediatrics, Loma Linda University, Loma Linda, California.
authors.forename: Mariam
authors.initials: M
authors.lastname: Ischander
authors.forename: Leland L
authors.initials: LL
authors.lastname: Fan
authors.forename: Vanda
authors.initials: V
authors.lastname: Farahmand
authors.forename: Claire
authors.initials: C
authors.lastname: Langston
authors.forename: Shahram
authors.initials: S
authors.lastname: Yazdani
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D006801:Humans; D006886:Hydroxychloroquine / Q000627:therapeutic use; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology*; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D020775:Thoracic Surgery, Video-Assisted; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D000893:Anti-Inflammatory Agents; D014028:Tobacco Smoke Pollution; D006886:Hydroxychloroquine; D008775:Methylprednisolone
keywords: child health; cigarette smoke; lung disease; pneumonitis