Challenging Cases in Paediatric Respiratory Medicine

Professor Andrew Bush MD FHEA FRCP FRCPCH FERS FAPSR ATSFProfessor of Paediatrics and Paediatric Respirology, National Heart and Lung Institute, and Centre for Paediatrics and Child Health, Imperial College (Foundation Director); Consultant Paediatric Chest Physician, Royal Brompton HospitalMy research interests include the invasive and non-invasive measurement of airway inflammation in children, in particular the use of endobronchial biopsy in the management of severe asthma, and clinical physiology, especially respiratory mass spectrometry. I have supervised more than 50 MD and PhD degrees, co-authored more than 800 papers in peer review journals, and written nearly 150 chapters in books and monographs. I am Deputy Editor of the American Journal of Respiratory and Critical Care Medicine. I have served as Guidelines Director of the European Respiratory Society and chair of the Publications Committee. I am also an emeritus NIHR Senior Investigator. Major recent awards include the British Thoracic Society medal (2022, the first Paediatrician to be so honoured), the 2024 James Spence Medal and an Honorary Life Fellowship, the highest honour of the RCPCH, and the 2024 ERS Presidential award. Most importantly, I have the nine greatest grandchildren in the world, Dylan and Jack in South Africa, Oscar and his twin siblings Aya and Fletcher, Lydia and Dominic, and Ilyas and Amina, all in London.Dr Thomas Semple MDres FRCRConsultant Radiologist (Cardiorespiratory and Paediatric Imaging), Royal Brompton Hospital, LondonHonorary Clinical Senior Lecturer, National Heart and Lung Institute and Centre for Paediatrics and Child Health, Imperial College LondonI have previously claimed to be the most spoiled paediatric radiologist in the world and stand by that claim. I took up a consultant position at the Royal Brompton in 2018 having completed an MDres at Imperial College supervised by Jane Davies, Simon Padley and Claire Hogg, applying structural and functional respiratory MRI to children and adults with cystic fibrosis. Prior to this, I studied respiratory and cardiac imaging with Dr Cathy Owens and Dr Michael Rubens who I consider not just mentors, but highly valued friends and role models and have also had the honour of working alongside Prof Bush and the whole Royal Brompton Paediatric Respiratory team, as well as the wider London Paediatric Respiratory Group reviewing cases, not just from in and around London, but from around the whole world.My research interests include the translation of subspecialty cardiorespiratory imaging techniques from adult practice into paediatrics; the development and optimisation of oxygen-enhanced MR imaging of respiratory physiology and radiation protection in paediatric CT. I have published peer reviewed original research and review papers covering the length and breadth of adult and paediatric respiratory and cardiac imaging practice, written chapters for multiple textbooks, lectured and taught on many courses around the world and sit on international taskforces for both respiratory and cardiac imaging. I am, however, most proud of my recent PhD students and the energy with which they strive to improve and advance practice in paediatric respiratory imaging as well as the increasingly international work of the Royal Brompton’s paediatric respiratory multidisciplinary team.

• 1. A young girl with an incidentally discovered mass on a chest radiograph2.The boy who coughs when vomiting and vomits when coughing3.A Neonate with Bleeding and Tracheobronchial Calcifications 4.A tale of two diagnoses5.A Child with Interstitial Lung Disease and Hepatic Cirrhosis6.Where is this baby’s left lung?7.Approaches to preventing infection and optimising airway clearance in a child with cerebral palsy8.Did God do it or did the Doctor do it? A diagnostic conundrum9. A Rare Pediatric Case of Chronic Lung Disease and ImmunodeficiencyTo biopsy – or not to biopsy?10. A Boy with a Hydropneumothorax who did not get better11.Unexplained hypoxemia in a toddler: a diagnostic journey12.A teenager who coughed up blood13.The Role of Flexible Bronchoscopy in Localizing Lymphatic Leak14.Respiratory distress in an infant born to a mother with tuberculosis in Cape Town15. BIG HEAD, STUBBORN LUNG: A QUIRKY CASE OF VENTRICULOMEGALY AND COLLAPSED LUNG16. A case of Pulmonary Hypertension: a challenge in LMICs17. A toddler with persistent productive cough and chest X-ray changes18. An Infant with Intermittent Wheeze19. PERSISTENT SEVERE WHEEZING IN A YOUNG CHILD FROM AN LMIC20. Recurrent Pneumonia and a Mediastinal Mass