Department of Pediatrics, Antwerp University Hospital, Edegem, Belgium.
Laboratory of Experimental Medicine and Pediatrics, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Pediatr Pulmonol. 2020 May;55(5):1259-1263. doi: 10.1002/ppul.24741. Epub 2020 Mar 23.
Children with Down syndrome (DS) often present with chronic respiratory symptoms. Congenital airway anomalies have been described but data about prevalence is scarce and a comparison to controls is lacking. We aim to compare the endoscopic and clinical data of children with DS to controls without significant medical history.
All endoscopic procedures under general anesthesia (broncho- and/or direct laryngoscopy) in patients with DS were reviewed. We compared clinical and endoscopic data to a cohort of children with respiratory symptoms but without any other relevant medical history.
Endoscopic data were available for 65 patients with DS. The median age was 2.9 years (range: 0.2-17), 63% were boys. The most common clinical presentation was recurrent respiratory infections (37%). Other major symptoms were chronic cough and/or noisy breathing (23%) and stridor (20%). Endoscopy was normal in 29% of patients. The largest group of patients (44%) had some form of airway malacia. Tracheal bronchus and subglottic stenosis were each isolated findings in 3.1% of patients. Twenty percent presented with combined airway anomalies. The control group consisted of 150 children (matched for age and sex) without significant underlying disease. The most common presentations were chronic cough and/or noisy breathing (29%), persistent radiographic abnormalities (20%), and suspicion of aspiration of a foreign body (15%). In the majority of controls (68%), no airway anomaly was found. Other findings were malacia (22%), tracheal bronchus (1%), and subglottic stenosis (1%). A combined anomaly was found in 5%.
Congenital airway anomalies were seen in 71% of patients with DS, compared with 32% of controls. Combined anomalies are more frequent in DS. Complete lower airway endoscopy is recommended in patients with DS as it may influence therapeutic decision-making.
唐氏综合征（DS）患儿常出现慢性呼吸系统症状。已描述过先天性气道异常，但有关其患病率的数据很少，且缺乏与对照组的比较。我们旨在比较 DS 患儿与无明显病史的对照组的内镜和临床数据。
回顾了所有在全麻下进行的（支气管镜和/或直接喉镜）内镜检查程序，以评估患有 DS 的患者。我们将临床和内镜数据与一组有呼吸系统症状但无其他相关病史的儿童进行了比较。
共获得 65 例 DS 患者的内镜数据。中位年龄为 2.9 岁（范围：0.2-17 岁），63%为男孩。最常见的临床表现为复发性呼吸道感染（37%）。其他主要症状为慢性咳嗽和/或呼吸杂音（23%）和喘鸣（20%）。29%的患者内镜检查正常。最大的一组患者（44%）存在某种形式的气道软化。气管支气管和会厌下狭窄分别在 3.1%的患者中孤立存在。20%的患者表现为联合气道异常。对照组由 150 名儿童（年龄和性别匹配）组成，他们没有明显的潜在疾病。最常见的表现为慢性咳嗽和/或呼吸杂音（29%）、持续的影像学异常（20%）和怀疑吸入异物（15%）。在大多数对照组（68%）中，未发现气道异常。其他发现为软化（22%）、气管支气管（1%）和会厌下狭窄（1%）。联合异常见于 5%的患者。
DS 患儿的先天性气道异常发生率为 71%，而对照组为 32%。联合异常在 DS 中更为常见。建议对 DS 患者进行完整的下气道内镜检查，因为这可能会影响治疗决策。
