Yang Kevin H, Kulatti Art, Sherer Kimberly, Rao Aparna, Cernelc-Kohan Mateja
Rady Children's Hospital, UC San Diego School of Medicine, San Diego, CA, United States.
Division of Respiratory Medicine, Rady Children's Hospital, San Diego, CA, United States.
Front Pediatr. 2022 Sep 6;10:918764. doi: 10.3389/fped.2022.918764. eCollection 2022.
Neuroendocrine cell hyperplasia of infancy (NEHI) is a rare childhood interstitial lung disease characterized by a gradual onset of tachypnea, hypoxemia, and failure to thrive in the first 2 years of life. NEHI is challenging to diagnose and can masquerade as common respiratory infections and reactive airway disease. Timely diagnosis is essential to optimize management of comorbidities, improve outcomes, and prevent unnecessary interventions. We report a case of a 14-month-old male who was hospitalized multiple times with recurrent episodes of presumed bronchiolitis. However, early on, the parents had detected unexplained nighttime hypoxemia with a wearable home pulse oximetry baby monitor. While recurrent respiratory infections are common in infancy, our patient had numerous persistent symptoms refractory to traditional treatments, which prompted further workup and ultimately led to the diagnosis of NEHI. The home baby monitor provided useful information that accelerated workup for a presentation that did not fit the usual picture of recurrent bronchiolitis, bronchospasm, or pneumonia. These devices that monitor infant cardiopulmonary status and oxygenation are becoming increasingly popular for home use. There is controversy over their clinical utility due to the frequency of false alarms, excessive parental reliance on these devices, and lack of Food and Drug Administration oversight to ensure accuracy and effectiveness of these devices. Our case provides an example of how in certain clinical settings, information from these devices might serve as a complementary tool in the pediatrician's medical decision-making and possibly lead to a rare diagnosis such as NEHI.
婴儿期神经内分泌细胞增生症（NEHI）是一种罕见的儿童间质性肺疾病，其特征为在生命的头两年逐渐出现呼吸急促、低氧血症和生长发育迟缓。NEHI的诊断具有挑战性，可能会被误诊为常见的呼吸道感染和反应性气道疾病。及时诊断对于优化合并症的管理、改善预后以及避免不必要的干预至关重要。我们报告一例14个月大的男性患儿，因疑似毛细支气管炎反复发作多次住院。然而，早期家长通过可穿戴式家用脉搏血氧仪婴儿监测器发现了不明原因的夜间低氧血症。虽然反复呼吸道感染在婴儿期很常见，但我们的患者有许多持续症状，对传统治疗无效，这促使进一步检查，最终确诊为NEHI。家用婴儿监测器提供了有用信息，加快了对不符合反复毛细支气管炎、支气管痉挛或肺炎常见表现的病情的检查。这些监测婴儿心肺状态和氧合的设备在家庭中越来越受欢迎。由于误报频率高（高）、家长过度依赖这些设备以及缺乏食品药品监督管理局的监管以确保这些设备的准确性和有效性，关于它们的临床实用性存在争议。我们的病例提供了一个例子，说明在某些临床环境中，这些设备提供的信息如何可能成为儿科医生医疗决策中的辅助工具，并可能导致罕见诊断，如NEHI。 （注：原文中“due to the frequency of false alarms, excessive parental reliance on these devices, and lack of Food and Drug Administration oversight to ensure accuracy and effectiveness of these devices.”部分翻译时括号内为补充完整语义的内容，使译文更通顺）
