Residual small airways lesions after kerosene pneumonitis in early childhood.

To assess residual lung damage after a single insult early in life, we studied 14 asymptomatic children, 10 years after an episode of kerosene pneumonitis. Immediately after kerosene ingestion all patients developed pulmonary symptoms. Eight had abnormal chest radiographs (group 1) whereas in six there were no radiographical changes (group 2). The average age at follow-up was 11.4 (range: 9.4-13.2). Lung volumes, expiratory flow-rates and their density dependence were measured and compared to an age, sex, and a height-matched control group. The volume of isoflow (Viso V) was significantly higher in patients in group 1 (27.75% +/- 6.7) when compared to group 2 (5.48% +/- 3.56) or controls (5.63% +/- 2.31) (P less than 0.02). The mean delta V max 50 was 13.5% +/- 3 for group 1, and 27.9% +/- 4.11 for group 2 (P less than 0.005). Airway reactivity assessed by an exercise test was normal in all children. Four of the eight patients from group 1 still had abnormal chest radiographs 10 years after kerosene pneumonitis. Thus, subclinical, prolonged small airway abnormalities after kerosene pneumonitis seem to be related to the severity of the acute insult.