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Abstract：
OBJECTIVE: To describe the clinical-radiological-pathological characteristics and treatment outcomes of children with suspected exogenous lipoid pneumonia (ELP).
METHODS: Systematic review. We searched electronic databases and reference lists published between 1967 and 2018, restricted to non-accidental cases.
RESULTS: Forty-four studies including 489 participants aged 1 day to 17 years from 13 countries were included. Cultural, medical, and behavioural rationale for oil-use was described. The clinical-radiological presentation varied widely. Diagnostic certainty was deemed highest if ELP was confirmed on bronchoalveolar lavage/frozen section lung biopsy with documented extracellular lipid on cytological staining and/or fat analysis. Non-tuberculous mycobacteria infection was identified in six studies: Mycobacterium fortuitum/chelonei, Mycobacterium smegmatis and Mycobacterium abscessus. Treatment comprised supportive therapy, corticosteroids, stopping oil, therapeutic lung-lavage and surgical resection. Outcomes were reported inconsistently.
CONCLUSIONS: Paediatric ELP resulting from cultural and medical practices continues to be described globally. Preventive interventions, standardized reporting, and treatment efficacy studies for cases not averted, are lacking. Protocol registration: PROSPERO CRD42017068313.
METHODS: Systematic review. We searched electronic databases and reference lists published between 1967 and 2018, restricted to non-accidental cases.
RESULTS: Forty-four studies including 489 participants aged 1 day to 17 years from 13 countries were included. Cultural, medical, and behavioural rationale for oil-use was described. The clinical-radiological presentation varied widely. Diagnostic certainty was deemed highest if ELP was confirmed on bronchoalveolar lavage/frozen section lung biopsy with documented extracellular lipid on cytological staining and/or fat analysis. Non-tuberculous mycobacteria infection was identified in six studies: Mycobacterium fortuitum/chelonei, Mycobacterium smegmatis and Mycobacterium abscessus. Treatment comprised supportive therapy, corticosteroids, stopping oil, therapeutic lung-lavage and surgical resection. Outcomes were reported inconsistently.
CONCLUSIONS: Paediatric ELP resulting from cultural and medical practices continues to be described globally. Preventive interventions, standardized reporting, and treatment efficacy studies for cases not averted, are lacking. Protocol registration: PROSPERO CRD42017068313.
摘要：
目的：描述疑似外源性类脂性肺炎（ELP）患儿的临床-放射学-病理学特征和治疗结果。
方法：系统评价。我们搜索了1967年至2018年之间发布的电子数据库和参考文献清单，仅限于非意外病例。
结果：纳入了44项研究，包括来自13个国家的1天至17岁的489名参与者。文化,medical,并描述了石油使用的行为基本原理。临床放射学表现差异很大。如果在支气管肺泡灌洗/冰冻切片肺活检中证实了ELP，并在细胞学染色和/或脂肪分析中记录了细胞外脂质，则诊断确定性被认为是最高的。在六项研究中确定了非结核分枝杆菌感染：偶然分枝杆菌/龟头，耻垢分枝杆菌和脓肿分枝杆菌。治疗包括支持疗法，皮质类固醇,停止石油，治疗性肺灌洗和手术切除。结果报告不一致。
结论：由文化和医疗实践产生的儿科ELP在全球范围内继续被描述。预防性干预措施,标准化报告，以及未避免病例的治疗效果研究，缺乏。协议注册：PROSPEROCRD42017068313。
方法：系统评价。我们搜索了1967年至2018年之间发布的电子数据库和参考文献清单，仅限于非意外病例。
结果：纳入了44项研究，包括来自13个国家的1天至17岁的489名参与者。文化,medical,并描述了石油使用的行为基本原理。临床放射学表现差异很大。如果在支气管肺泡灌洗/冰冻切片肺活检中证实了ELP，并在细胞学染色和/或脂肪分析中记录了细胞外脂质，则诊断确定性被认为是最高的。在六项研究中确定了非结核分枝杆菌感染：偶然分枝杆菌/龟头，耻垢分枝杆菌和脓肿分枝杆菌。治疗包括支持疗法，皮质类固醇,停止石油，治疗性肺灌洗和手术切除。结果报告不一致。
结论：由文化和医疗实践产生的儿科ELP在全球范围内继续被描述。预防性干预措施,标准化报告，以及未避免病例的治疗效果研究，缺乏。协议注册：PROSPEROCRD42017068313。
