Diffuse lung disease in infancy and childhood: expanding the chILD classification
Article first published online: 9 OCT 2013
© 2013 John Wiley & Sons Ltd
Volume 63, Issue 6, pages 743–755, December 2013
How to Cite
2013) Histopathology 63, 743–755 Diffuse lung disease in infancy and childhood: expanding the chILD classification, , & (
- Issue published online: 15 NOV 2013
- Article first published online: 9 OCT 2013
- Accepted manuscript online: 10 MAY 2013 09:55AM EST
- Manuscript Accepted: 2 MAY 2013
- Manuscript Received: 28 FEB 2013
- National Institute of Health Research Respiratory Disease Biomedical Research Unit at the Royal Brompton Hospital
- Harefield NHS Foundation Trust
- Imperial College London
- chILD classification;
- interstitial lung disease;
Diffuse parenchymal lung diseases (DPLD) in children comprise a wide spectrum of rare disorders. In 2007 the Children's Interstitial Lung Disease (chILD) Research Cooperative proposed a classification system for DPLD in children <2 years of age. The aims of our study were to determine the utility and reproducibility of this system in children <2 years of age, and test its extension to 18 years of age.
Methods and results
Of 211 cases, 93 were <2 years of age at presentation and 58% were included in the chILD classification. In 118 cases aged between 2 and 18 years there was a wider distribution of disorders, overlapping with those seen in adults, necessitating expansion of the chILD classification types to encompass all reviewed cases, in particular patients with ‘adult’ diffuse lung diseases. Many cases showed mixed histological patterns, overlap often being between groups of disorders more prevalent in infancy. Concordance between reporting pathologists was 90%.
The chILD scheme allows classification of conditions more common in children <2 years of age. It can be applied to children of any age, although additional entities need to be included. We propose a more histologically based system for use when assessing biopsies in this context.