放射性肺损伤是小儿甲状腺癌治疗中放射性碘治疗（RAIT）的罕见并发症。在本病例报告中，我们描述了一名患有 ERC1::RET 阳性经典乳头状甲状腺癌的儿科患者，在针对淋巴结和肺部疾病进行 RAIT 后出现进行性呼吸道症状和胸部影像学异常。一名 ERC1::RET 阳性儿科患者典型的甲状腺乳头状癌在接受一剂经验剂量的 RAIT 后三个月因肺代偿失调而住院。测试显示没有感染或肺转移进展的证据，肺炎的经验性抗生素治疗也没有改善。尽管进行了经验性抗炎治疗，但从呼吸角度来看，患者仍然有症状，需要补充氧气，并且胸部影像学显示有纤维化变化的证据。该患者的肺部状况与辐射引起的肺损伤（包括肺纤维化的发展）一致。随着 RET 融合靶向抑制剂的出现，该病例凸显了放射性碘的罕见肺部副作用，可供临床医生识别。前期靶向治疗方案可能有助于避免放射性碘相关的不良反应。 Karger AG，巴塞尔。

Radiation-induced lung injury is a rare complication of radioactive iodine therapy (RAIT) in pediatric thyroid cancer treatment. In this case report, we describe a pediatric patient with an ERC1::RET-positive classic papillary thyroid carcinoma who developed progressive respiratory symptoms and chest imaging abnormalities following RAIT for lymph node and pulmonary disease.A pediatric patient with ERC1::RET-positive classic papillary thyroid carcinoma was hospitalized for pulmonary decompensation three months following one empiric dose of RAIT. Testing revealed no evidence of infection or progression of pulmonary metastases, and there was no improvement with empiric antibiotic therapy for pneumonia. Despite empiric anti-inflammatory therapies, the patient remains symptomatic from a respiratory standpoint with requirement for supplemental oxygen and evidence of fibrotic changes on chest imaging.This patient's pulmonary condition is consistent with radiation-induced pulmonary injury including development of pulmonary fibrosis. With the availability of RET fusion targeted inhibitors, this case highlights a rare pulmonary side effect of radioactive iodine for clinicians to recognize. Upfront targeted therapy protocols may help avoid radioactive iodine-associated adverse reactions.S. Karger AG, Basel.