THE SPECTRUM OF PATHOLOGICAL-CHANGES IN THE LUNG IN CHILDREN WITH THEACQUIRED-IMMUNODEFICIENCY-SYNDROME - AN AUTOPSY STUDY OF 36 CASES

We present the pulmonary findings in 36 autopsies of children affected by the acquired immunodeficiency syndrome (AIDS). Twenty-three patien ts were male and 13 were female, ranging in age between 3 days and 13 years. Twenty children had human immunodeficiency virus (HIV)-positive parents or parents who were at high risk of exposure (intravenous dru g abusers and prostitutes), five had a history of transfusion, and one had a history of renal transplantation and blood transfusion. Clinica lly, the patients presented with recurrent infections, failure to thri ve, hepatosplenomegaly, fever, cough, and/or hemoptysis. Histologicall y, specific infectious processes were the most common finding (75% of cases), with Pneumocystis carinii pneumonia being the most prevalent t ype of infection, followed by bacterial pneumonia. Neoplastic conditio ns and lymphoid interstitial pneumonia were less frequent (approximate ly 10% of cases). In addition, in approximately 10% of the cases the p ulmonary findings were non-specific (ie, pulmonary edema and atelectas is) and probably unrelated to HIV infection. Our findings suggest that specific infectious conditions constitute the most common type of pul monary pathology in children with AIDS. However, because there is a sm all percentage of children with nonspecific finding, a transbronchial biopsy is important for proper evaluation before institution of therap y. HUM PATHOL 25:877-882. This is a US government work. There are no r estrictions on its use.