Chronic obstructive pulmonary diseases in children.
OBJECTIVE
To verify and describe the main events related to the diagnosis and management of chronic obstructive pulmonary diseases in children (COPDC) and adolescents, considering the interrelated physiopathology, genetic, and environmental characteristics.


METHODS
Relevant literature from PubMed was selected and reviewed.


RESULTS
COPDC have an environmental and/or genetic origin and its manifestation has manifold genotypes, phenotypes, and endotypes. Although COPDC has no cure, it can be clinically controlled. Chronic cough is the main symptom and bronchiectasis can be present in several COPDC patients. The management of COPDC is more effective if based on guidelines and when treatment regimen adherence is promoted. Oral and inhaled corticosteroids, bronchodilators, inhaled antibiotics, and treatment of pulmonary exacerbation (PE) are the bases of COPDC management, and should be individualized for each patient.


CONCLUSIONS
Correct diagnosis and knowledge of risk factors and comorbidities are essential in COPDC management. Procedures and drugs used should be based on specific guidelines for each COPDC case. Treatment adherence is critical to obtain the benefits of management. COPDC clinical control must be evaluated by the decrease in PEs, improved quality of life, reduction of pulmonary function loss, and lung structural damage. For most cases of COPDC, monitoring by interdisciplinary teams in specialized reference centers with surveillance strategies and continuous care leads to better outcomes, which must be evaluated by decreasing pulmonary function damage and deterioration, better prognosis, better quality life, and increased life expectancy.
Department of Pediatrics, Faculdade de Ciências Médicas (FCM), Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brazil. Electronic address: jdirceuribeiro@gmail.com.
Jose Dirceu
JD
Ribeiro
Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil.
Gilberto Bueno
GB
Fischer
D000293:Adolescent; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002908:Chronic Disease; D003266:Continuity of Patient Care; D003371:Cough / Q000209:etiology; D006801:Humans; D017410:Practice Guidelines as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology
Child; Chronic cough; Chronic obstructive pulmonary disease; Criança; Doença pulmonar obstrutiva crônica; Tosse crônica