CHLOROQUINE TREATMENT OF INTERSTITIAL LUNG-DISEASE IN CHILDREN

Seven children aged 3 months to 11 years with histologically confirmed interstitial lung disease (ILD) [6 with desquamative interstitial pne umonitis (DIP) and I with chronic interstitial pneumonitis] were treat ed with chloroquine, 10 mg/kg/day. One patient, diagnosed late in the course of the disease, died after three weeks of treatment, despite th e addition of systemic corticosteroids. Another patient responded to c ombined therapy with chloroquine and prednisone and had a normal lung biopsy after 6 months of treatment. He underwent surgical repair of mi tral valve stenosis and died after extensive brain infarction. The oth er 5 patients responded well to chloroquine therapy with major improve ment in oxygenation within a few weeks and in lung function over the n ext few months. They remained well clinically and physiologically, inc luding a normal response to incremental exercise, during a mean follow -up period of 9.8 years (range 3.5 to 15.7 years). None of the patient s has developed retinopathy or any other ocular complication. Bronchoa lveolar ravage was a useful tool for evaluation of the activity of the disease (predominance of neutrophils) in 3 out of 4 patients. We sugg est that chloroquine should be considered as an effective treatment in ILD in children. Incremental exercise test may be helpful for routine follow-up and evaluation of the efficacy of a specific treatment. (C) 1994 Wiley-Liss, Inc.