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Varghese NP, Austin ED, Galambos C, Mullen MP, Yung D, Guillerman RP, Vargas SO, Avitabile CM, Chartan CA, Cortes-Santiago N, Ibach M, Jackson EO, Jarrell JA, Keller RL, Krishnan US, Patel KR, Pogoriler J, Whalen EC, Wikenheiser-Brokamp KA, Villafranco NM, Hopper RK, Usha Raj J, Abman SH. An interdisciplinary consensus approach to pulmonary hypertension in developmental lung disease. Eur Respir J 2024; 64:2400639. [PMID: 39147412 PMCID: PMC11424926 DOI: 10.1183/13993003.00639-2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/16/2024] [Indexed: 08/17/2024]
Abstract
It is increasingly recognised that diverse genetic respiratory disorders present as severe pulmonary hypertension (PH) in the neonate and young infant, but many controversies and uncertainties persist regarding optimal strategies for diagnosis and management to maximise long-term outcomes. To better define the nature of PH in the setting of developmental lung disease (DEVLD), in addition to the common diagnoses of bronchopulmonary dysplasia and congenital diaphragmatic hernia, we established a multidisciplinary group of expert clinicians from stakeholder paediatric specialties to highlight current challenges and recommendations for clinical approaches, as well as counselling and support of families. In this review, we characterise clinical features of infants with DEVLD/DEVLD-PH and identify decision-making challenges including genetic evaluations, the role of lung biopsies, the use of imaging modalities and treatment approaches. The importance of working with team members from multiple disciplines, enhancing communication and providing sufficient counselling services for families is emphasised to create an interdisciplinary consensus.
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Affiliation(s)
- Nidhy P Varghese
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Eric D Austin
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Csaba Galambos
- Department of Pathology and Laboratory Medicine, University of Colorado and Pediatric Heart Lung Center, Children's Hospital Colorado, Aurora, CO, USA
| | - Mary P Mullen
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Delphine Yung
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - R Paul Guillerman
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Sara O Vargas
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Catherine M Avitabile
- Division of Cardiology, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Corey A Chartan
- Department of Pediatrics, Divisions of Critical Care Medicine and Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | | | - Michaela Ibach
- Section of Palliative Care, Division of Hospital Medicine, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Emma O Jackson
- Heart Center, Pulmonary Hypertension Program, Seattle Children's Hospital, Seattle, WA, USA
| | - Jill Ann Jarrell
- Division of Palliative Care, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Roberta L Keller
- Department of Pediatrics/Neonatology, University of California San Francisco and Benioff Children's Hospital, San Francisco, CA, USA
| | - Usha S Krishnan
- Department of Pediatrics, Division of Pediatric Cardiology, Columbia University Irving Medical Center and Morgan Stanley Children's Hospital of New York Presbyterian Hospital, New York, NY, USA
| | - Kalyani R Patel
- Department of Pathology and Immunology, Texas Children's Hospital, Houston, TX, USA
| | - Jennifer Pogoriler
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Elise C Whalen
- Department of Pediatrics, Division of Pulmonology, Advanced Practice Providers, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Kathryn A Wikenheiser-Brokamp
- Department of Pathology and Laboratory Medicine, University of Cincinnati College of Medicine and Division of Pathology & Laboratory Medicine and The Perinatal Institute Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Natalie M Villafranco
- Department of Pediatrics, Division of Pulmonology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Rachel K Hopper
- Department of Pediatrics, Division of Cardiology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - J Usha Raj
- Department of Pediatrics, Division of Neonatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Steven H Abman
- Department of Pediatrics, University of Colorado and Pediatric Heart Lung Center, Children's Hospital Colorado, Aurora, CO, USA
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Lin YB, Xia B, Cao J, Tang ZJ. Ultrasound findings in neonates with alveolar capillary dysplasia with misalignment of the pulmonary veins: report of two cases. J Int Med Res 2022; 50:3000605221126876. [PMID: 36173014 PMCID: PMC9528008 DOI: 10.1177/03000605221126876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 08/30/2022] [Indexed: 02/05/2023] Open
Abstract
Alveolar capillary dysplasia with misalignment of the pulmonary veins (ACDMPV) is a rare congenital pulmonary disease that affects newborns. Most patients with ACDMPV are born at full term and are healthy. The main clinical manifestations are refractory pulmonary hypertension and pulmonary failure with gastrointestinal, urinary, or cardiac malformations. ACDMPV often progresses rapidly, but no conventional biological or imaging tests other than genetic testing are available for its diagnosis. Lung biopsy is currently the gold standard for diagnosis. We herein report two cases of ACDMPV confirmed by pathological examination and discuss their ultrasonographic findings.
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Affiliation(s)
- Yan-bing Lin
- Department of Ultrasound, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
| | - Bei Xia
- Department of Ultrasound, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
- Shantou University Medical College, Shantou, Guangdong, China
- Bei Xia, Department of Ultrasound, Shenzhen Children’s Hospital, 7019 Yitian Road, Shenzhen 518026, China. E-mail:
| | - Juan Cao
- Department of Pathology, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
| | - Zi-Jian Tang
- Department of Ultrasound, Shenzhen Children’s Hospital, Shenzhen, Guangdong, China
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