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Lung biopsy in infants with SEVERE bronchopulmonary dysplasia
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  • Danielle A. Callaway,
  • yifei WANG,
  • Krithika Lingappan,
  • Jennifer Pogoriler,
  • Pablo Laje,
  • Kathleen Nilan,
  • Haresh Kirpalani,
  • Huayan Zhang
Danielle A. Callaway
The Children's Hospital of Philadelphia Division of Neonatology
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yifei WANG
Guangdong Provincial People's Hospital
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Krithika Lingappan
The Children's Hospital of Philadelphia Division of Neonatology
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Jennifer Pogoriler
The Children's Hospital of Philadelphia Department of Pathology and Laboratory Medicine
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Pablo Laje
The Children's Hospital of Philadelphia
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Kathleen Nilan
The Children's Hospital of Philadelphia Division of Neonatology
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Haresh Kirpalani
The Children's Hospital of Philadelphia Division of Neonatology
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Huayan Zhang
The Children's Hospital of Philadelphia Division of Neonatology

Corresponding Author:[email protected]

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Abstract

Introduction Lung biopsy is infrequently utilized in the population of infants with severe bronchopulmonary dysplasia (BPD). Yet, its presentation may overlap with other infant diffuse lung diseases, including those within the spectrum of childhood interstitial lung diseases (chILD). Lung biopsy might differentiate between these entities, or discern those with an extremely poor prognosis. Both might alter the clinical management of a subset of infants diagnosed with BPD. Methods In this tertiary referral center, we drew on a retrospective cohort of 306 preterm infants with severe BPD. Of these, nine underwent lung biopsy between 2012 and 2017. Our aim was to assess the indication of lung biopsy, the prior clinical history, safety of the procedure, and describe the biopsy findings. Finally, we considered management decisions in relation to the biopsy results in these patients. Results The average gestational age and birth weight of the 9 patients were 30±3 (range 27-34) weeks and 1421±571 (range 611-2140) grams. All infants had serial echocardiograms to assess for pulmonary hypertension, genetic testing, and computed tomography angiography (CTA) prior to biopsy. All patients showed moderate to severe alveolar simplification and 8 had some degree of pulmonary interstitial glycogenosis (PIG) ranging from focal to diffuse. Following biopsy, 2 infants with findings of PIG received high dose systemic steroids and 2 separate infants had care redirected. Conclusion In our cohort, lung biopsy was safe and well tolerated. Findings from lung biopsy may aid decision making in selected patients when used as a part of a step-wise diagnostic algorithm.
19 Dec 2022Submitted to Pediatric Pulmonology
19 Dec 2022Submission Checks Completed
19 Dec 2022Assigned to Editor
19 Dec 2022Review(s) Completed, Editorial Evaluation Pending
21 Dec 2022Reviewer(s) Assigned
06 Jan 2023Editorial Decision: Revise Minor
04 Mar 20231st Revision Received
10 Mar 2023Assigned to Editor
10 Mar 2023Submission Checks Completed
10 Mar 2023Review(s) Completed, Editorial Evaluation Pending
10 Mar 2023Reviewer(s) Assigned
22 Mar 2023Editorial Decision: Revise Minor
11 Apr 20232nd Revision Received
11 Apr 2023Submission Checks Completed
11 Apr 2023Assigned to Editor
11 Apr 2023Reviewer(s) Assigned
11 Apr 2023Review(s) Completed, Editorial Evaluation Pending
17 Apr 2023Editorial Decision: Accept