Natural History and Treated Course of Usual and Desquamative Interstitial Pneumonia

Carrington, Charles B.; Gaensler, Edward A.; Coutu, Ronald E.; FitzGerald, M. X.; Gupta, Raj G.

doi:10.1056/nejm197804132981501

Cited by 732 publications

(413 citation statements)

References 30 publications

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“…withtemporal heterogeneity [13]. Desquamative interstitial pneumonia is much less common but has a better prognosis than usual interstitial pneumonia, with a good responseto corticosteroids [13,15]. Its patho logic hallmark is diffuse intraalveolar mac rophage accumulation [13].…”

Section: Foamy Cell Collections In Alveolar Spacesmentioning

confidence: 99%

Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings.

Kim¹,

Lee²,

Chung³

et al. 1998

American Journal of Roentgenology

163

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OBJECTIVE. The purposeof our studywas to describehigh-resolutionCT findingsof nonspecific interstitial pneumonia with fibrosis and to compare findings seen on CT with pathologic findings. MATERIALS AND METHODS. High-resolutionCT findingsof biopsy-provennonspecific interstitial pneumonia with fibrosis from 23 consecutive patients (one man and 22 women) were analyzed retrospectively by two chest radiologists. CT findings were compared with pathologic findings.RESULTS. The predominant high-resolution CT finding,seenin all patients,wasbilateral patchy areasof ground-glass opacity with (35%) or without (65%) areasof consolidation. Ir regular linear opacities (87%), thickening of bronchovascular bundles (65%), and bronchial dilatation (52%) were also frequently seen. Honeycombing was not seen in any patient. All parenchymal abnormalities showed subpleural predominance. Areas of ground-glass opacity with or without irregular linear opacity or bronchial dilatation on CT correspondedpathologi cally to areasof interstitial thickening causedby varying degreesof interstitial inflammation and fibrosisshowingtemporaluniformity.Areas of consolidation, seenat five biopsysites, represented the areas of bronchiolitis obliterans organizing pneumonia, foamy cell collections in alveolar spaces,or microscopic honeycombing with mucin stasis. CONCLUSION.On high-resolutionCT, nonspecificinterstitialpneumoniawith fibrosis is most commonly revealed as patchy subpleural areasof ground-glass opacity mixed with ir regular linear opacity or bronchial dilatation. These areas represent interstitial thickening caused by varying degrees of interstitial inflammation, fibrosis, or both.

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Section: Foamy Cell Collections In Alveolar Spacesmentioning

confidence: 99%

Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings.

Kim¹,

Lee²,

Chung³

et al. 1998

American Journal of Roentgenology

163

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“…diopathic pulmonary fibrosis (IPF) is a chronic progressive interstitial lung disease (ILD) of unknown cause, resulting in severe morbidity and death due to progressive respiratory failure [1], usually within 3-5 yrs [2][3][4][5]. Prognostic factors that have been variably associated with survival include age [6], smoking status [7], sex [8], resting pulmonary function [9], histopathology score [7], fibrotic score based on high-resolution computed tomography [10,11], and initial response to treatment with corticosteroids [10].…”

mentioning

confidence: 99%

The timed walk test as a measure of severity and survival in idiopathic pulmonary fibrosis

Hallstrand

Boitano

Johnson

et al. 2005

European Respiratory Journal

164

112

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Idiopathic pulmonary fibrosis (IPF) is a relentlessly progressive disease with a median survival of ,3 yrs. Measurements of airflow and lung volumes at rest are generally used to monitor the clinical course in this disorder. This study was designed to determine if a modified version of the 6-min walk test, called the timed walk test, accurately characterises disease severity and survival in IPF.The study population consisted of 28 patients with well-characterised progressive IPF. The timed walk test and concurrent measures of disease severity were assessed at baseline. Participants were prospectively followed for o4 yrs to determine the relationship between parameters of the timed walk test and survival.There were strong correlations between the end-exercise saturation and walk-velocity parameters of the timed walk test and diffusing capacity, and arterial oxygen tension at rest. In univariate Cox proportional-hazards models, end-exercise saturation, change in saturation with exercise, walk distance and walk velocity were associated with survival. In unadjusted logistic regression models, odds of death at 2 yrs were associated with the same parameters.In conclusion, the timed walk test relates to disease severity and long-term outcome in progressive idiopathic pulmonary fibrosis.

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“…After discontinuation of the steroid therapy, no recurrence was detected, and the long‐term prognosis is considered good. As Carrington et al 2 previously reported, the extent of lung fibrosis is thought to be important in the prognosis of DIP. Further accumulation of cases and investigation are needed.…”

Section: Discussionmentioning

confidence: 91%

Desquamative interstitial pneumonia complicated by diffuse alveolar haemorrhage

Matsuo

Matsumoto

Kitamura

et al. 2017

Respirology Case Reports

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We report a rare case of desquamative interstitial pneumonia (DIP) with diffuse alveolar haemorrhage (DAH). A 56‐year‐old man diagnosed with DIP by surgical lung biopsy 2 years ago was admitted to our hospital because of severe acute respiratory failure. The DIP had progressed despite smoking cessation. On admission, the patient appeared extremely ill, and physical examination revealed respiratory distress. The patient required mechanical ventilation. High‐resolution computed tomography showed diffuse ground glass opacity in both lungs. The bronchoalveolar lavage fluid was bloody, and numerous haemosiderin‐laden alveolar macrophages were detected. Pulse steroid therapy followed by oral prednisolone immediately relieved the respiratory failure and improved the long‐term control of the DIP. Paired sera tests confirmed the diagnosis of influenza A/H3N2 virus infection, which was the cause of the DAH. Chronically progressive DIP with acute respiratory failure due to DAH was successfully treated by steroid therapy.

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Natural History and Treated Course of Usual and Desquamative Interstitial Pneumonia

Cited by 732 publications

References 30 publications

Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings.

Nonspecific interstitial pneumonia with fibrosis: high-resolution CT and pathologic findings.

The timed walk test as a measure of severity and survival in idiopathic pulmonary fibrosis

Desquamative interstitial pneumonia complicated by diffuse alveolar haemorrhage

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