Introduction. Chronic obstructive pulmonary disease (COPD) is conventionally considered as adult smokers disease, related to airway inflammation and remodeling. However, some studies proved that COPD could rarely affect children.

Aim. To investigate the anthropometric, clinical, and functional features of COPD in a group of Tunisian children.

Methods. It was a cross sectional study, over a period of two years. Twenty one children who matched the spirometric definition of COPD were included. They underwent pre- and post-bronchodilator spirometry. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and forced mid-expiratory flow (FEF25-75%) in percentage, pre- and post-bronchodilator were collected. COPD diagnosis was retained, according to GOLD, as the post- bronchodilator FEV1/FVC ratio was less than 0.7.

Results. Median age and body mass index were 13 [8 14] years and 14.6 [13.5 17.5] kg/m², respectively. Seventeen (81%) of the children were boys and 10 (48%) were underweight. Active and passive smokers were 12% and 75%, respectively. Diagnosed chronic pulmonary diseases found in these children were primary ciliary dyskinesia (30%), asthma (24%) and bronchiectasis (10%). Respiratory symptoms were found in half of the children. Mean FEV1, FEF25-75% and FVC in percentage (pre- vs post-bronchodilator) were 47±18% vs 52±20%, 69±22% vs 75±23% and 28±21% vs 26±12%, respectively. GOLD stages were 1, 2, 3 and 4 in 14%, 29%, 43% and 14% of the children, respectively.

Conclusion. Children with chronic lung disease such as primary ciliary dyskinesia are more likely to develop COPD. The follow-up relies on pulmonary function tests. Therefore, a revision of the diagnostic criteria should be considered.