Cellular Interstitial Pneumonitis in Children: Response to Hydroxychloroquine Treatment in Two Cases

Abstract

We describe two children with biopsy confirmed cellular interstitial pneumonitis (CIP). The first child, a 5.5-year-old girl, presented at 3 years of age with respiratory distress and decreased exercise tolerance. Open-lung biopsy was consistent with CIP. She was initially treated with prednisolone. After 2 months hydroxychloroquine was begun because of lack of response to corticosteroid therapy, and the patient had a significant response within 1 month. The patient has been maintained successfully on continuous treatment with hydroxychloroquine only for more than 3 years since this treatment was started. The second patient, a 9-month-old boy presented with tachypnea, cough, and hemoglobin desaturation. After confirmation of the diagnosis by lung biopsy and initial failure of response to oral prednisolone, hydroxychloroquine was begun while steroids were discontinued, with a rapid improvement. Four months later, the infant remains asymptomatic, with normal auscultatory findings and oxygen saturation above...