### Learning points A 16-year-old boy with persisting fixed obstructive spirometry is approaching transition to adult services. He has been under long-term follow-up, initially referred aged 2 months by his local team for tachypnoea and mild respiratory distress since birth. He was born at term by vaginal delivery with meconium suctioned from his oropharynx and admitted to a special care baby unit for observation and intravenous antibiotics. Chest X-ray (CXR) at birth was reportedly consistent with possible meconium aspiration, although there was no neonatal resuscitation or ventilation required and he was discharged home after 4 days without an oxygen requirement. Flexible bronchoscopy was arranged that was unremarkable, there was no evidence of aspiration or infection, he had a negative congenital infection screen and normal echocardiogram. CT chest showed linear atelectasis, occasional thickened interlobular septa and areas of secondary pulmonary lobular hyperinflation. Neither bronchopulmonary dysplasia (BPD) nor meconium aspiration syndrome really fits his neonatal history or imaging appearance. He was well in himself and so was discharged with a plan for regular outpatient review. Follow-up CT chest age 3 years (figure 1A) demonstrated persistent abnormality with an …

中文翻译：

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儿童间质性肺病：端粒的简短教训

### 学习要点 一名 16 岁男孩持续进行固定阻塞性肺活量测定，即将过渡到成人服务。他一直在接受长期随访，最初在 2 个月大时被当地团队转诊为呼吸急促和自出生以来的轻度呼吸窘迫。他通过阴道分娩足月出生，从他的口咽部吸出胎粪，并被送入特殊护理婴儿病房进行观察和静脉注射抗生素。据报道，出生时的胸部 X 光片 (CXR) 与可能的胎粪吸入一致，尽管不需要新生儿复苏或通气，并且他在 4 天后出院回家，不需要氧气。软式支气管镜检查无异常，无误吸或感染，先天性感染筛查阴性，超声心动图正常。胸部CT显示线状肺不张，偶有小叶间隔增厚和继发性肺小叶过度充气区。支气管肺发育不良 (BPD) 和胎粪吸入综合征都不符合他的新生儿病史或影像学表现。他对自己很好，因此出院时有定期门诊复查的计划。随访 CT 胸部年龄 3 岁（图 1A）显示持续异常与…