Once other possible causes of lung disease symptoms have been eliminated, neonates and infants with childhood interstitial lung disease (ILD) syndrome should be evaluated by a knowledgeable subspecialist, according to new guidelines from the American Thoracic Society.

The guidelines were formed based on observational evidence and clinical experience of the multidisciplinary panel and are designed to help clinicians navigate the evaluation and management of children with this complex constellation of diseases.

The guidelines, which were published in the August 1 issue of the ATS journal American Journal of Respiratory and Critical Care Medicine, describe the clinical characteristics of neonates and infants with diffuse lung disease (DLD); list the common causes of DLD that should be eliminated during the evaluation of neonates and infants with DLD; recommend methods for further clinical investigation of the remaining infants, who are regarded as having “childhood ILD syndrome;” describe a new pathologic classification scheme of DLD in infants; outline supportive and continuing care; and suggest areas for future research.

“The characteristics and natural history of ILD differ in children and adults,” said Geoffrey Kurland, M.D., of the Division of Pediatric Pulmonology at the Children’s Hospital of Pittsburgh and a member of the committee that drafted the guidelines. “These new guidelines specifically address the diagnostic evaluation and management of chILD in neonates and infants, as most of the new diagnostic entities that have been recently described affect infants disproportionately.”