title: An official American Thoracic Society clinical practice guideline: classification, evaluation, and management of childhood interstitial lung disease in infancy.
abstract: BACKGROUND
  There is growing recognition and understanding of the entities that cause interstitial lung disease (ILD) in infants. These entities are distinct from those that cause ILD in older children and adults.
  
  
  METHODS
  A multidisciplinary panel was convened to develop evidence-based guidelines on the classification, diagnosis, and management of ILD in children, focusing on neonates and infants under 2 years of age. Recommendations were formulated using a systematic approach. Outcomes considered important included the accuracy of the diagnostic evaluation, complications of delayed or incorrect diagnosis, psychosocial complications affecting the patient's or family's quality of life, and death.
  
  
  RESULTS
  No controlled clinical trials were identified. Therefore, observational evidence and clinical experience informed judgments. These guidelines: (1) describe the clinical characteristics of neonates and infants (<2 yr of age) with diffuse lung disease (DLD); (2) list the common causes of DLD that should be eliminated during the evaluation of neonates and infants with DLD; (3) recommend methods for further clinical investigation of the remaining infants, who are regarded as having "childhood ILD syndrome"; (4) describe a new pathologic classification scheme of DLD in infants; (5) outline supportive and continuing care; and (6) suggest areas for future research.
  
  
  CONCLUSIONS
  After common causes of DLD are excluded, neonates and infants with childhood ILD syndrome should be evaluated by a knowledgeable subspecialist. The evaluation may include echocardiography, controlled ventilation high-resolution computed tomography, infant pulmonary function testing, bronchoscopy with bronchoalveolar lavage, genetic testing, and/or lung biopsy. Preventive care, family education, and support are essential.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Kurland
authors.forename: Robin R
authors.initials: RR
authors.lastname: Deterding
authors.forename: James S
authors.initials: JS
authors.lastname: Hagood
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Young
authors.forename: Alan S
authors.initials: AS
authors.lastname: Brody
authors.forename: Robert G
authors.initials: RG
authors.lastname: Castile
authors.forename: Sharon
authors.initials: S
authors.lastname: Dell
authors.forename: Leland L
authors.initials: LL
authors.lastname: Fan
authors.forename: Aaron
authors.initials: A
authors.lastname: Hamvas
authors.forename: Bettina C
authors.initials: BC
authors.lastname: Hilman
authors.forename: Claire
authors.initials: C
authors.lastname: Langston
authors.forename: Lawrence M
authors.initials: LM
authors.lastname: Nogee
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: Redding
mesh_terms: D002648:Child; D003948:Diagnostic Techniques, Respiratory System / Q000592:standards*; D019468:Disease Management; D006801:Humans; D007223:Infant; D017563:Lung Diseases, Interstitial / Q000145:classification / Q000175:diagnosis / Q000628:therapy; D017410:Practice Guidelines as Topic; D012955:Societies, Medical; D014481:United States
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