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ABSTRACT: Background
Surfactant metabolism disorders may result in diffuse lung disease in children.Case presentation
We report a 3-years-old boy with dry cough, progressive hypoxemia, dyspnea and bilateral ground glass opacities at chest high-resolution computed tomography (HRCT) who had no variants in genes encoding surfactant proteins or transcription factors. Lung histology strongly suggested an abnormality of surfactant protein. A 7-month course of pulse intravenous high-dose methylprednisolone plus oral hydroxychloroquine and azithromycin led to gradual weaning from oxygen and oral steroids, and to improvement of cough and dyspnea. Over the follow-up period, hydroxychloroquine and azithromycin were not withdrawn as cough and dyspnea re-appeared at each attempt and disappeared at re-start. At 6 years of age chest HRCT still appeared unchanged, but clinical symptoms or signs were absent.Conclusions
In children suspected of inborn errors of pulmonary surfactant metabolism who do not have a recognized genetic mutation, lung biopsy with consistent histology may help physicians to address the definitive diagnosis.
SUBMITTER: Montella S
PROVIDER: S-EPMC4658764 | biostudies-literature | 2015 Nov
REPOSITORIES: biostudies-literature

Montella Silvia S Vece Timothy J TJ Langston Claire C Carrera Paola P Nogee Lawrence M LM Hamvas Aaron A Manna Angelo A Cervasio Mariarosaria M Santamaria Francesca F
Italian journal of pediatrics 20151125
<h4>Background</h4>Surfactant metabolism disorders may result in diffuse lung disease in children.<h4>Case presentation</h4>We report a 3-years-old boy with dry cough, progressive hypoxemia, dyspnea and bilateral ground glass opacities at chest high-resolution computed tomography (HRCT) who had no variants in genes encoding surfactant proteins or transcription factors. Lung histology strongly suggested an abnormality of surfactant protein. A 7-month course of pulse intravenous high-dose methylpr ...[more]