Abstract

Children with Down syndrome (DS) are more prone to have respiratory disorders which can be categorized into congenital structural disorders of the airways and lungs, acquired disorders, and sleep-related disorders and obstructive sleep apnea. Children with DS have a high incidence of airway anomalies; both upper and lower compared to non-DS children. The most important findings are hypoplasia of midface with dysfunction of malformed Eustachian tube, a short palate, hypoplastic nasal bones, choanal stenosis, macroglossia, enlarged adenoids and tonsils, lingual tonsils, and narrow oropharynx, and nasopharynx, abnormal oropharyngeal structures, laryngomalacia, tracheomalacia, congenital subglottic stenosis, tracheo-oesophageal fistula, bronchomalacia and branching and lung anomalies. Among the acquired respiratory disorders encountered in children with DS are respiratory infections including acute bronchiolitis due to infection with respiratory syncytial virus, pneumonia, infection with H1n1 stains of flu virus, high incidence of acute lung injury, occurrence of pulmonary hemosiderosis, increase incidence of pulmonary hypertension, GERD, and the possibility of having asthma. Sleep disorders are common and important problems, frequently under-recognized in children with DS and can be a significant distressing factor to their families. The prevalence of these disorders in children with DS is very high, particularly in boys. Vaccinations help to prevent a considerable number of infectious diseases. The immune dysfunctions of DS are not a contraindication for the currently available vaccines: their immunogenicity and safety are not significantly different from those observed in the general population.