Lung ultrasound in children and adolescents with rheumatologic diseases in clinical practice

Abstract

Pulmonary complications from autoimmune diseases are rare in the pediatric age group, but with significant morbidity, compromising the patients’ quality of life in adulthood. The objective of this study was to evaluate the presence of interstitial lung disease in pediatric rheumatologic patients with connective tissue diseases, who were submitted to investigation through lung ultrasound during outpatient follow-up. The medical records of 40 patients were reviewed from April 2014 to December 2021. The patients evaluated were those who had already undergone lung ultrasound and presented changes suggestive of interstitial lung disease and were submitted to complementary investigation with chest high-resolution computed tomography and pulmonary function tests. The sample consisted of 20 patients, 70% of whom were female. The average age was 14 years. Half of the patients with connective tissue diseases showed changes suggesting pulmonary fibrosis on lung ultrasound and underwent further investigation with chest high-resolution computed tomography and pulmonary function test. In this group, 40% had tomography with abnormal patterns in the lung parenchyma, suggestive of interstitial lung disease, predominantly with normal spirometry. Older age and longer duration of disease were statistically significant in the analysis between the group with both altered imaging tests and the 20 patients underwent lung ultrasound (p= 0.008 and p= 0.006, respectively). Lung ultrasound can be a valuable screening tool for the early detection of interstitial lung changes in pediatric collagenosis. Larger prospective and longitudinal studies are needed in the pediatric age group, so that its specificity for interstitial syndrome can be determined.