Clinicopathologic features of acute interstitial pneumonia

Jeong Shim Jae Jeong Shim, Muyn Park Sang Muyn Park, Hwa Lee Sang Hwa Lee, Gu Lee Jin Gu Lee, Yun Cho Jae Yun Cho, Gyu Song Gwan Gyu Song, Ho In Kwang Ho In, Hwa Yoo Se Hwa Yoo, Ho Kang Kyung Ho Kang

Research output: Contribution to journalArticle

Abstract

Background: Acute interstitial pneumonia is a relatively rare form of interstitial pneumonia, since the vast majority of interstitial pneumonia have a more chronic course. It corresponds to the lesion described by Hamman and Rich, as Hamman-Rich disease in 1944. Another name in the clinical literature is accelerated interstitial pneumonia, idiopathic acute respiratory distress syndrome (idiopathic ARDS), and the organizing stage of diffuse alveolar damage. Acute interstitial pneumonia differs from chronic interstitial pneumonia by clinical and pathologic features. Clinically, this disease is characterized by a sudden onset and a rapid course, and reversible disease. Method and Purpose: Five causes of pathologically proven acute interstitial pneumonia were retrospectively studied to define the clinical, radiologic, and pathologic features. Results: 1) The five cases ranged in age from 31 to 77 years old. The onset of illness was acute in all patients, it began with vital-like prodrome 6 - 40 days prior to shortness of breath, and respiratory failure eventually developed in all patients. In 2 cases, generalized skin rash was accompanied with flu-like symptoms. Etiologic agent could not be identified in any case. 2) All patients had leukocytosis and severe hypoxemia. Pulmonary function test of 3 available cases shows restrictive ventilatory defect, and one survived patient(case 5) has a complete improvement of pulmonary function after dismissal. 3) Diffuse bilateral chest infiltrates were present radiologically. Theses were the ground-glass, consolidation, and reticular densities without honeycomb fibrosis in all patients. The pathologic abnormalities were the presence of increased numbers of macrophages and the formation of hyaline membranes within alveolar spaces. There was also interstitial thickening with edema, proliferation of immature fibroblast, and hyperplasia of type 11 pneumocyte. In the survived patient(case5), pathologic findings were relatively early stage of acute interstitial pneumonia, such as hyaline membrane with mild interstitial fibrosis. 4) Of the 5 patients, four patients died of respiratory failure 14-90 days after onset of first symptom, and one survived and recovered in symptoms, chest X ray, and pulmonary function test. Conclusion: These results emphasize that acute interstitial pneumonia is clinically, radiologically, and pathologically distinct form of interstitial pneumonia and should be separated from the group of chronic interstitial pneumonia. Further studies will be needed to evaluate the pathogenesis and the treatment of acute interstitial pneumonia.

Original languageEnglish
Pages (from-to)58-66
Number of pages9
JournalTuberculosis and Respiratory Diseases
Volume42
Issue number1
Publication statusPublished - 1995 Jan 1

Keywords

  • Acute interstitial pneumonia

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Infectious Diseases

Cite this

Jae Jeong Shim, J. S., Sang Muyn Park, M. P., Sang Hwa Lee, H. L., Jin Gu Lee, G. L., Jae Yun Cho, Y. C., Gwan Gyu Song, G. S., Kwang Ho In, H. I., Se Hwa Yoo, H. Y., & Kyung Ho Kang, H. K. (1995). Clinicopathologic features of acute interstitial pneumonia. Tuberculosis and Respiratory Diseases, 42(1), 58-66.