Hypersensitive pneumonitis in children. Clinical experience

Background. The most common form of interstitial lung disease in children is hypersensitivity pneumonitis (HP). The study of clinical and epidemiological features, variability of etiological factors, approaches to treating the disease is an urgent problem in pediatric pulmonology.

Objective. Analysis of the features of the clinical picture and the variability of specific allergens in HP in children.

Methods. 13 children with HP were examined on the basis of the Pulmonology Department of the Regional Children’s Clinical Hospital named after. N.N. Silishcheva in the period from January 1, 2022 to April 30, 2023. The diagnosis was based on the characteristic clinical picture, the results of radiological diagnostics and functional respiratory tests, as well as a history of contact with a potentially provoking antigen followed by an immunological examination.

Results. During the follow-up period, 13 patients with HP were identified. The clinical picture of the disease was characterized by typical manifestations in the form of signs of intoxication, respiratory failure, crepitus during auscultation of the lungs, while the severity of respiratory failure was associated with the age of the patients. A number of patients were diagnosed with comorbid pathology in the form of bronchial asthma and allergic rhinitis. Fungal antigens and bird allergens in the examined children were the most significant factors causing HP. The main strategy for the treatment of HP was the elimination of the trigger factor and the use of systemic glucocorticosteroids in therapy, which contributed to a favorable outcome of the disease in acute cases and remission in chronic cases.

Conclusion. The study shows that the number of diagnosed cases in the region is increasing. HP debuts in the first years of life; it is characterized by heterogeneity of the clinical picture at different age periods of childhood with variability of causally significant agents, but the leading positions are occupied by fungal allergens and bird allergens.