Limits...
The First Successful Heart-Lung Transplant in a Korean Child with Humidifier Disinfectant-Associated Interstitial Lung Disease.

Jhang WK, Park SJ, Lee E, Yang SI, Hong SJ, Seo JH, Kim HY, Park JJ, Yun TJ, Kim HR, Kim YH, Kim DK, Park SI, Lee SO, Hong SB, Shim TS, Choi IC, Yu J - J. Korean Med. Sci. (2016)

Bottom Line: Moreover, in several familial cases, the disease affected young women and children simultaneously.Epidemiologic, animal, and post-interventional studies identified the cause as inhalation of humidifier disinfectants.Here, we report a 4-year-old girl who suffered from severe progressive respiratory failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Asan Medical Center Children's Hospital, College of Medicine, University of Ulsan, Seoul, Korea .

ABSTRACT
From 2006 to 2011, an outbreak of a particular type of childhood interstitial lung disease occurred in Korea. The condition was intractable and progressed to severe respiratory failure, with a high mortality rate. Moreover, in several familial cases, the disease affected young women and children simultaneously. Epidemiologic, animal, and post-interventional studies identified the cause as inhalation of humidifier disinfectants. Here, we report a 4-year-old girl who suffered from severe progressive respiratory failure. She could survive by 100 days of extracorporeal membrane oxygenation support and finally, underwent heart-lung transplantation. This is the first successful pediatric heart-lung transplantation carried out in Korea.

No MeSH data available.


Related in: MedlinePlus

Serial follow-up of radiologic examination before transfer to our hospital. (A) Initial chest x-ray showed normal chest radiography. (B) Chest radiograph taken one month after symptom develop revealed diffuse haziness in both lung field. (C) Diffuse reticulo-nodular opacities in both lung fields were aggravated and pneumomediastinum along the bilateral mediastinum were developed after two months. (D) A high-resolution CT scan performed 2 weeks after symptom onset revealed peribronchial and subpelural consolidation, especially in dependent portion of both lower lobes. (E) A follow-up CT scan performed 2 months later showed increased diffuse ground glass opacities with traction bronchiectasis and cystic lesions in both lungs. Pulmonary interstitial emphysema in the left lower lobe and pneumomediastinum also detected.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4835612&req=5

Figure 1: Serial follow-up of radiologic examination before transfer to our hospital. (A) Initial chest x-ray showed normal chest radiography. (B) Chest radiograph taken one month after symptom develop revealed diffuse haziness in both lung field. (C) Diffuse reticulo-nodular opacities in both lung fields were aggravated and pneumomediastinum along the bilateral mediastinum were developed after two months. (D) A high-resolution CT scan performed 2 weeks after symptom onset revealed peribronchial and subpelural consolidation, especially in dependent portion of both lower lobes. (E) A follow-up CT scan performed 2 months later showed increased diffuse ground glass opacities with traction bronchiectasis and cystic lesions in both lungs. Pulmonary interstitial emphysema in the left lower lobe and pneumomediastinum also detected.

Mentions: A 4-year-old girl was transferred to our hospital with a 2-month history of progressive respiratory problems. Initially, she developed a mild dry cough with no underlying lung disease. However, she developed dyspnea and tachypnea about 2 weeks after initial symptom onset, which became progressively worse and necessitated admission to a tertiary hospital to which her mother and 1-year-old sister had been admitted several days earlier suffering from similar symptoms. The patient was initially diagnosed with chILD of unknown origin and was treated with methyl prednisolone, hydroxychloroquine, and cyclophosphamide. However, the clinical symptoms and radiologic findings worsened (Fig. 1), which brought her to our hospital at June 11th, 2011. Unfortunately, her younger sister could not be transferred and expired one week after her transfer. The patient and her family members had used HD which-contained polyhexamethylene-guanidine (PHMG) as one of components.


The First Successful Heart-Lung Transplant in a Korean Child with Humidifier Disinfectant-Associated Interstitial Lung Disease.

Jhang WK, Park SJ, Lee E, Yang SI, Hong SJ, Seo JH, Kim HY, Park JJ, Yun TJ, Kim HR, Kim YH, Kim DK, Park SI, Lee SO, Hong SB, Shim TS, Choi IC, Yu J - J. Korean Med. Sci. (2016)

Serial follow-up of radiologic examination before transfer to our hospital. (A) Initial chest x-ray showed normal chest radiography. (B) Chest radiograph taken one month after symptom develop revealed diffuse haziness in both lung field. (C) Diffuse reticulo-nodular opacities in both lung fields were aggravated and pneumomediastinum along the bilateral mediastinum were developed after two months. (D) A high-resolution CT scan performed 2 weeks after symptom onset revealed peribronchial and subpelural consolidation, especially in dependent portion of both lower lobes. (E) A follow-up CT scan performed 2 months later showed increased diffuse ground glass opacities with traction bronchiectasis and cystic lesions in both lungs. Pulmonary interstitial emphysema in the left lower lobe and pneumomediastinum also detected.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4835612&req=5

Figure 1: Serial follow-up of radiologic examination before transfer to our hospital. (A) Initial chest x-ray showed normal chest radiography. (B) Chest radiograph taken one month after symptom develop revealed diffuse haziness in both lung field. (C) Diffuse reticulo-nodular opacities in both lung fields were aggravated and pneumomediastinum along the bilateral mediastinum were developed after two months. (D) A high-resolution CT scan performed 2 weeks after symptom onset revealed peribronchial and subpelural consolidation, especially in dependent portion of both lower lobes. (E) A follow-up CT scan performed 2 months later showed increased diffuse ground glass opacities with traction bronchiectasis and cystic lesions in both lungs. Pulmonary interstitial emphysema in the left lower lobe and pneumomediastinum also detected.
Mentions: A 4-year-old girl was transferred to our hospital with a 2-month history of progressive respiratory problems. Initially, she developed a mild dry cough with no underlying lung disease. However, she developed dyspnea and tachypnea about 2 weeks after initial symptom onset, which became progressively worse and necessitated admission to a tertiary hospital to which her mother and 1-year-old sister had been admitted several days earlier suffering from similar symptoms. The patient was initially diagnosed with chILD of unknown origin and was treated with methyl prednisolone, hydroxychloroquine, and cyclophosphamide. However, the clinical symptoms and radiologic findings worsened (Fig. 1), which brought her to our hospital at June 11th, 2011. Unfortunately, her younger sister could not be transferred and expired one week after her transfer. The patient and her family members had used HD which-contained polyhexamethylene-guanidine (PHMG) as one of components.

Bottom Line: Moreover, in several familial cases, the disease affected young women and children simultaneously.Epidemiologic, animal, and post-interventional studies identified the cause as inhalation of humidifier disinfectants.Here, we report a 4-year-old girl who suffered from severe progressive respiratory failure.

View Article: PubMed Central - PubMed

Affiliation: Department of Pediatrics, Asan Medical Center Children's Hospital, College of Medicine, University of Ulsan, Seoul, Korea .

ABSTRACT
From 2006 to 2011, an outbreak of a particular type of childhood interstitial lung disease occurred in Korea. The condition was intractable and progressed to severe respiratory failure, with a high mortality rate. Moreover, in several familial cases, the disease affected young women and children simultaneously. Epidemiologic, animal, and post-interventional studies identified the cause as inhalation of humidifier disinfectants. Here, we report a 4-year-old girl who suffered from severe progressive respiratory failure. She could survive by 100 days of extracorporeal membrane oxygenation support and finally, underwent heart-lung transplantation. This is the first successful pediatric heart-lung transplantation carried out in Korea.

No MeSH data available.


Related in: MedlinePlus