ORGANIZING PNEUMONIA IN CHILDREN: EPIDEMIOLOGY, ETIOLOGICAL STRUCTURE, CLINICAL AND COMPUTED TOMOGRAPHIC SEMIOTICS, COMORBIDITY, THERAPY
Authors:   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia, Petryaykina E.S. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Kolganova N.I. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia, Ovsyannikov D.Yu. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia,   Morozov Children’s City Clinical Hospital, Moscow, Russia,   Moscow City Children's Infectious Diseases Hospital No. 6 of the Moscow Department of Healthcare, Moscow, Russia, Ayrapetyan M.I. ,   Pirogov Russian National Research Medical University, Moscow, Russia,   I.M. Sechenov First Moscow State Medical University, Moscow, Russia, Bulynko S.A. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Gitinov Sh.A. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Gorev V.V. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Zhakota D.A. ,   Pirogov Russian National Research Medical University, Moscow, Russia, Zhdanova O.I. ,   Moscow City Children's Infectious Diseases Hospital No. 6 of the Moscow Department of Healthcare, Moscow, Russia, Zhestkova M.A. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia, Zakirov I.I. ,   Kazan State Medical Academy (Branch of the Russian Medical Academy for Continuous Professional Education in Moscow, Russia), Kazan, Republic of Tatarstan, Russia,   Kazan and the Volga Region Federal University, Kazan, Republic of Tatarstan, Russia, Zinnatullin I.R. ,   Children's Republican Clinical Hospital with the Ministry of Healthcare of the Republic of Tatarstan, Kazan, Republic of Tatarstan, Russia, Illarionova T.Yu. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia, Karpenko M.A. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia,   Moscow City Children's Infectious Diseases Hospital No. 6 of the Moscow Department of Healthcare, Moscow, Russia, Konstantinova A.K. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Kurbanova S.Kh. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Malyshev O.G. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia, Marchenkov Ya.V. ,   AO GK MEDSI, Russian Federal Private Clinics Network, Moscow, Russia, Mitina N.A. ,   Patrice Émery Lumumba People’s Friendship University of Russia, Moscow, Russia, Nguyen B.V. ,   Thái Nguyên University (TNU), Thái Nguyên, Việt Nam, Ovsyannikov A.D. ,   MIREA - Russian Technological University, Moscow, Russia, Petryaykin F.A. ,   M.V. Lomonosov Moscow State University, Moscow, Russia, Petryaykina E.E. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia,   Pirogov Russian National Research Medical University, Moscow, Russia, Rtishchev A.Yu. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia,   Pirogov Russian National Research Medical University, Moscow, Russia, Safina A.I. ,   Kazan State Medical Academy (Branch of the Russian Medical Academy for Continuous Professional Education in Moscow, Russia), Kazan, Republic of Tatarstan, Russia, Soldatskiy Yu.L. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Tereshchenko M.N. ,   Pirogov Russian National Research Medical University, Moscow, Russia, Topilin O.G. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia, Turina I.E. ,   I.M. Sechenov First Moscow State Medical University, Moscow, Russia, Tsverava A.G. ,   Morozov Children’s City Clinical Hospital, Moscow, Russia
Published: October 2023

Organizing pneumonia (OP) is an interstitial lung disease (ILD), which is characterized by the proliferation of granulation tissue in the bronchioles and alveoli, and diagnosed on the basis of clinical history, morphological data, CT changes and response to glucocorticoid (GC) therapy. Information about OP in children is limited due to the insufficient number of cases described and observed. The purpose of this research was to establish the epidemiological characteristics, etiological structure, clinical and CT semiotics of OP in children, to characterize its comorbidity and therapy. Materials and methods used: 20 children aged 4 months to 17 years old with OP were observed in 2009-2023. The diagnosis was set based on the clinical and anamnestic data, the presence of specific CT patterns, positive clinical and radiological dynamics during GC therapy, and (in 2 cases) according to histological examination results. Results: the ratio of boys to girls was 1.8:1, most often OP was diagnosed in infants (40%) and young children (30%) with various comorbid diseases with a frequency of 0.012‰ in the structure of all hospitalized patients of a multidisciplinary hospital in Moscow (Russia) in 2014-2022 The reasons for the acute (80%) and subacute (20%) OP were respiratory infections (40%), aspiration (30%), diffuse connective tissue diseases (DCTD) (10%), in a single case the OP had developed as part of lung injury associated with vaping and electronic cigarettes (EVALI), 15% of patients had an idiopathic version of OP (cryptogenic OP). The clinical picture of OP was characterized by shortness of breath (100%), cough (90%), fever, rales/crepitus (65%), wheezing (45%); the chest CT scan (n=19) showed zones of consolidation (100%), including subpleural localization (84%), trapezoidal shadowing (27%), zones of “ground glass” (68%), reversed halo sign (32%). Therapy included GC (95%), azithromycin (40%), mechanical ventilation (40%), oxygen therapy (60%). Clinical and radiological improvement occurred in 18 (90%) children, and death occurred in 2 (10%) children. Conclusion: OP is a rare variant of ILD whose reasons in children can be respiratory infections, aspiration, DCTD, EVALI. The effectiveness of GC in the presence of characteristic symptoms and CT images confirms the diagnosis.