Acute interstitial pneumonia: report of a series

A, Bonaccorsi; Cancellieri, Alessandra; Chilosi, Marco; Trisolini, Rocco; Boaron, Maurizio; Crimi, Nunzio; Poletti, Venerino

doi:10.1183/09031936.03.00297002

Cited by 70 publications

(58 citation statements)

References 21 publications

(25 reference statements)

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“…AIP is frequently confused with acute multilobar infectious pneumonia, with other forms of interstitial pneumonia, such as acute exacerbation of idiopathic pulmonary fibrosis, rapidly progressive bronchiolitis obliterans-organising pneumonia or idiopathic acute eosinophilic pneumonia, with collagen-vascular diseases involving the lungs and with primary or secondary pulmonary capillaritis. 5 Most patients are adults, but AIP has been reported in a wide age range from as young as 7 to over 80 years old, with a mean age of 54 years old. 9 No gender variation exists.…”

Section: Fig 3: Hrct Showing Diffuse Areas Of Pulmonary Infiltrationmentioning

confidence: 99%

“…In 1935, Hamman and Rich first described pulmonary fibrosis of unknown cause in 4 patients with acute diffuse interstitial fibrosis who died within 1-6 months of presentation. 3,4,5 Acute interstitial pneumonia, which occurs over a wide range of ages, with an approximate mean age of 54. 6 AIP is radiologically and physiologically resembles acute respiratory distress syndrome (ARDS).…”

Section: Introductionmentioning

confidence: 99%

“…6 AIP is radiologically and physiologically resembles acute respiratory distress syndrome (ARDS). 5 The chest radiographic and high resolution computed tomography (HRCT) scan manifestations of AIP are bilateral and sometimes patchy, and there are alveolar densities associated to areas of ground glass attenuation. 5 Lung biopsy is confirmatory for AIP and it shows the organizing form of diffuse alveolar damage (DAD) pattern.…”

Section: Introductionmentioning

confidence: 99%

“…5 The chest radiographic and high resolution computed tomography (HRCT) scan manifestations of AIP are bilateral and sometimes patchy, and there are alveolar densities associated to areas of ground glass attenuation. 5 Lung biopsy is confirmatory for AIP and it shows the organizing form of diffuse alveolar damage (DAD) pattern. 7 Due to the rarity of this entity, the clinical profile, laboratory data and treatment are not well defined.…”

Section: Introductionmentioning

confidence: 99%

“…High-dose corticosteroids and cyclophosphamide are the drugs usually used. 5,8 However, AIP show a very poor prognosis, with high mortality and remains unfamiliar to physicians. In this report, we present a case of a mid-age male with AIP who, was treated with intensive medical facilities, still showed a rapid progressive clinical deterioration, and eventually died of respiratory failure.…”

Section: Introductionmentioning

confidence: 99%

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Acute interstitial pneumonia (hamman-rich syndrome) - a life threatening respiratory disease

et al. 2018

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Abstract:Acute interstitial pneumonia (AIP) is an idiopathic lung disease characterized by rapidly progressive dyspnoea, respiratory failure developing over days to weeks in patients without pre-existing lung disease. AIP show a very poor prognosis, with high mortality and remains unfamiliar to physicians. In this report, we present a case of a mid-age male with AIP who, was treated with intensive medical facilities, still showed a rapid progressive clinical deterioration, and eventually died of respiratory failure.

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Section: Fig 3: Hrct Showing Diffuse Areas Of Pulmonary Infiltrationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute interstitial pneumonia (hamman-rich syndrome) - a life threatening respiratory disease

et al. 2018

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Alveolar Diseases

2006

Diffuse Lung Diseases

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Although the etiology and pathogenesis are unknown, the lung damage is thought to be caused by the release of toxic oxygen species and proteases by polymorphonuclear neutrophils Mean age at onset is 50 years. Both sexes are equally affected and there is no correlation with tobacco smoking There are no known risk factors CLINICAL FEATURES The onset is acute and the most common presenting symptoms are cough (100%), dyspnea (80-100%) and fever. Patients often report a prodromal flu-like illness (joint and muscle pain, fever, chills and malaise) Physical examination reveals tachypnea and peripheral cyanosis. In 50% of cases fine rales can be heard throughout the lung fields All patients have reduced DLCO and a restrictive pattern. Moderate to severe hypoxemia, at times refractory to oxygen therapy, rapidly ensues. Rapid progression to respiratory failure similar to acute respiratory distress syndrome (ARDS) is common Vourlekis JS. Acute interstitial pneumonitis. Case series and review of the literature. Medicine 2000, 79: 369 PATHOLOGY The histologic features of AIP are those of diffuse alveolar damage (DAD): • Acute (exudative) phase, rarely biopsied: hyaline membranes, an expression of acute epithelial damage, line the alveolar walls. The alveolar septa show edema and varying amounts of acute and chronic inflammatory infiltrate. Thromboses of small and medium-size arterioles are common • Organizing (proliferative) phase: proliferation of myofibroblasts that migrate from the interstitium to the alveolar spaces: the hyaline membranes (A) are resorbed and organized within the alveolar septa, which become thickened (). Proliferation of hyperplastic type II pneumocytes restores the alveolar epithelium • Chronic (fibrotic) phase: dense fibrosis with possible distortion of lung architecture Definition Etiology and pathogenesis Epidemiology Risk factors History Physical findings Basic lesions Pulmonary function tests Diffuse Lung Diseases Maffessanti & Dalpiaz AIP ☯ Diffuse (alveoli and alveolar septa) Histopathologic differential diagnoses: • DAD associated with infections: granulomas, viral inclusions, necrotic foci, abscesses; identification of the microorganism with special stains • DAD superimposed on UIP (accelerated UIP): associated with the characteristic UIP pattern • DAD due to other causes: not idiopathic but secondary to other causes (shock, trauma, physical or chemical causes, etc.) • OP: predominantly intraalveolar foci of fibroblastic organization, intense inflammatory infiltrate, bronchiolar involvement (not constant)

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