Pathology of the respiratory system in children with Down syndrome

Abstract

Down’s syndrome is the most frequent chromosomal abnormality. According to the literature, respiratory diseases are the most frequent reasons of hospitalization of children with Down’s syndrome. Also, respiratory diseases are diagnosed for 42% of patients with Down’s syndrome during first two years of life. Objective. Objective is to define features of respiratory diseases course for children with Down’s syndrome to determine the best cure tactics. Materials and methods. Six patients with Down’s syndrome and damage to respiratory system at age of from 2 month to 7 years were under observation. Medical documentation, anamnesis data, CT scan of the thorax organs and objective examination data has been analyzed. Results. Abnormal pregnancy has been confirmed for 4 patients, 50% of patients had been born premature. Congenital heart defects had been diagnosed for 5 patients. Four patients suffered lower respiratory tract diseases with respiratory failure at an early age, cure in intensive care unit or pulmonary department has been required. Later recurrent respiratory diseases were observed. One patient was referred to a pulmonologist by a doctor of another specialty in early childhood. Shortness of breath of mixed or insular type, cough, cyanosis, night apnea, physically observed strengthening wheezing during respiratory infections, for 4 patients - mosaic performance of breathing has been clinically recorded. According to the results of the X-ray examination, the changes are - «ground-glass opacity» - 5 patients, subpleural cysts - 4 patients, uneven ventilation - all. Two patients have radiological evidence of lymphoid interstitial pneumonitis. subsequently all patients were observed by a pulmonologist, prescribed pathogenetic treatment with inhalation glucocorticostroids, and two children received systemic glucocorticosteroids with positive effects. The X-ray dynamics showed a regression of alveolar infiltration for 6-9 months, as well as a decrease in shortness of breath, an improvement in physical activity tolerance, objectively - no strengthening wheezing by four years for 4 patients. Conclusion. Children with Down’s syndrome and respiratory failure from an early age require specialized pulmonological care. Timely diagnosis and optimal therapeutic strategies are critical to ensure treatment outcomes.