Treatment of children with bronchial obstruction syndrome on the background of connective tissue dysplasia: realities and prospects

BACKGROUND: According to Rosstat, respiratory diseases are the most common reason for children to seek medical help. Anatomical and physiological features of the child’s body and infectious factors predispose to the development of bronchial obstruction syndrome. The scientific literature describes that the presence of connective tissue dysplasia (CTD) worsens the course of bronchial obstruction syndrome. It is important to detect CTD in children with respiratory diseases, as they require more invasive examination methods. This group of patients has specific features of therapy, they need more careful dynamic monitoring.

AIM: Identification of CTD based on phenotypic signs and study of its features in patients of the pediatric pulmonology department with bronchial obstruction syndrome and chronic bronchial inflammation, assessment of the severity of the disease, analysis of examination methods and therapy.

MATERIALS AND METHODS: The article presents data from a one-stage cohort study of 380 patients with bronchoobstructive syndrome who received inpatient treatment in the conditions of the pulmonology department of the St. Petersburg State Medical Institution “K.A. Rauhfus Children’s City Clinical Center of High Medical Technologies”, in the period from 2019 to 2022.

RESULTS: Conventional therapy, which is used to treat bronchial asthma, is not always effective for patients with CTD. Pediatric patients with CTD and bronchial asthma who are being treated in the pulmonology department are subjected to greater radiation exposure and procedures with a higher level of invasiveness, including fibrobronchoscopy.

CONCLUSIONS: Children with CTD are characterized by a burdened anamnesis of bronchopulmonary pathology (complicated course of pneumonia, spontaneous pneumothorax), the absence of complicated heredity by atopy. In the group of children with CTD, the prevalence of severe bronchial asthma and obliterating bronchiolitis was revealed. Examination of patients with CTD requires expensive diagnostic studies (computed tomography of the chest organs, fibrobronchoscopy), in the acute period of the disease — the appointment of systemic glucocorticosteroids, humanized monoclonal anti-IgE drugs are used to treat the disease.