Interstitial lung disease in children: a multicentre survey on diagnostic approach

Chronic interstitial lung disease (ILD) is a rare disorder in the paediatri c age group, with a poor prognosis. The diagnostic approach to ILD is based on more or less invasive methods. This study was implemented to verify whi ch methods are the most often used in children. Questionnaires (333) were sent to members of the European Respiratory Socie ty Paediatric Assembly belonging to 187 European and non-European centres. Questions concerned the use of noninvasive diagnostic methods, e.g. history taking, physical examination, routine laboratory tests, respiratory functi on tests and radiology (chest radiography, high-resolution computed tomogra phy (HRCT)), and the use of invasive techniques such as bronchoalveolar lav age (BAL), transbronchial biopsy (TBB), open lung biopsy (OLB), video-assis ted thoracoscopic biopsy (VAT) and HRCT with fine-needle aspiration biopsy (FNAB). Thirty eight centres returned the questionnaires and 131 children,vith ILD were studied. A diagnosis of LLD was achieved in five (3.8%) patients using noninvasive techniques alone. Using the various biopsy methods, histologic al assessment was performed on a total of 98 (74.8%) children. The most fre quently used invasive technique both alone and in combination was BAL (83, 63.3%), followed by OLB (64, 48.8%), TBB (26, 19.8%) and VAT (11, 8.4%); FN AB was used in one patient. In conclusion a diagnosis of interstitial lung disease was reached on the b asis of aetiological and/or histological findings in 117 (89%) of the 131 p atients studied.