PEDIATRICS Vol. 44 No. 2 August 1969, pp. 179-195
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CHRONIC RESPIRATORY DISTRESS IN THE PREMATURE INFANT

Wilson-Mikity Syndrome

Joan E. Hodgman M.D.1, Victor G. Mikity M.D.1, Dorothy Tatter M.D.1, and Robert S. Cleland M.D.1

1 Department of Pediatrics, Radiology, and Pathology, University of Southern California School of Medicine, and the Los Angeles County-University of Southern California Medical Center, Los Angeles

Thirty-four premature infants with Wilson-Mikity syndrome were seen during a 7-year period. Insidious onset of mild respiratory symptoms usually began after the first week of life. These symptoms became increasingly severe and reached maximum intensity from 4 to 8 weeks later. One quarter of the infants died during this stage. In survivors, the respiratory symptoms cleared slowly over the next months and completely disappeared in all but one infant by 2 years of age.

The chest radiograph was consistent and distinctive. Diffuse, streaky infiltrate with small cystic areas appeared during the first stage and progressed as the clinical symptoms increased. The second stage was characterized by basilar hyperaeration with residual strands in the upper lobes. These changes slowly cleared as the clinical symptoms disappeared.

Eleven lung biopsies were performed, and all 12 infants who died were autopsied. The pathologic picture progressed from an early, immature pattern through areas of hyperinflation and collapse in the first stage, to diffuse overinflation during the second stage. Two infants had pulmonary fibrosis.

We consider the most likely pathogenesis of the syndrome to be an abnormal air distribution with a disturbance in ventilation/perfusion ratios secondary to characteristics of the immature lung.

Submitted on March 6, 1969
Accepted on March 26, 1969




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