title: [Trisomy 21 syndrome associated interstitial lung disease: a case report].
abstract: OBJECTIVE
  To study the pathology, imaging and clinical features of a child with trisomy 21 syndrome associated interstitial lung disease.
  
  
  METHODS
  Data of a case with trisomy 21 syndrome associated interstitial lung disease confirmed by lung imaging and pathology were collected, analyzed and the related reports in literature were reviewed.
  
  
  RESULTS
  The patient was a one year and 7 months old boy who suffered from severe pneumonia and recurrent infection during his hospital stay. When his disease was stable, he did not have shortness of breath and cyanosis, but a chest computed tomography (CT) showed ground-glass opacity, regional emphysema, band-like change in lung parenchyma, which indicated interstitial lung diseases. Unequal air inflation in bilateral lungs and diffuse over-distension of peripheral air spaces in lung surface were seen through thoracoscope. Pathological examination indicated that alveolar, alveolar ducts and alveolar sac were enlarged, alveolar septa was expanded. There were two reports in lung pathology of trisomy 21 syndrome, alveolar growth abnormalities was seen in 86%-88% cases. The multiple subpleural cysts in chest CT was characteristic. Clinically, trisomy 21 syndrome had high morbidity of respiratory tract infection and progress to respiratory failure frequently. Prolonged postoperative desaturation was constant which required long duration of respiratory support.
  
  
  CONCLUSIONS
  Trisomy 21 syndrome associated alveolar growth abnormalities were confirmed, which manifest as alveolar simplification in pathology and interstitial lung diseases in imaging. The risk of respiratory failure in these cases caused by infection and surgery should be considered.
authors.affiliation: Division of Respiratory Disease, Shenzhen Children's Hospital, Shenzhen 518026, China.
authors.forename: Jiehua
authors.initials: J
authors.lastname: Chen
authors.forename: Hongling
authors.initials: H
authors.lastname: Ma
authors.affiliation: Email: yuejiez@sina.com.
authors.forename: Yuejie
authors.initials: Y
authors.lastname: Zheng
authors.forename: Juan
authors.initials: J
authors.lastname: Cao
authors.forename: Hongwu
authors.initials: H
authors.lastname: Zeng
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
mesh_terms: D003560:Cysts / Q000473:pathology; D004314:Down Syndrome / Q000150:complications*; D006801:Humans; D007223:Infant; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D011184:Postoperative Period; D011650:Pulmonary Alveoli / Q000473:pathology; D012131:Respiratory Insufficiency; D012141:Respiratory Tract Infections; D014057:Tomography, X-Ray Computed