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KMID : 0371619990150020255
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Journal of Wonkwang Medical Science
1999 Volume.15 No. 2 p.255 ~ p.259
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A case of Acute Interstitial Pneumonia
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Kim Kyoung-Hee
Yang Sei-Hoon
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Abstract
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Most interstitial pneumonias are chronic processes characterized by an insidious onset of dyspnea and cough followed by slowly progressive deterioration of the lung function. Less often, acute interstitial pneumonia(AIP) presents acutely with respiratory failure developing after several days. The coarse of illness is short, and most patient die within weeks or months. In 1944, Hamman and Rich described four patients with fatal fulminant lung disease that, at autopsy, was characterized as extensive pulmonary fibrosis. they termed the condition "acute diffuse interstitial fibrosis of the lungs." The clinopathologic process that Hamman and Rich described has also been referred as the accelerated variant of interstitial pneumonitis, acute interstitial pneumonia, and fulminant idiopathic pulmonary fibrosis. The term "Hamman-Rich syndrome" has also been applied to other entities, particularly chronic interstitial pneumonia. Acute interstitial pneumonia observed a characteristic pattern of bilateral ground glass opacification, with or without air-space consolidation, in a patchy or diffuse distribution on high-resolution computed tomography. The pathologic hallmark of AIP was defined as diffuse alveolar damage(DAD). DAD is manifested by injury to the alveolar lining and endothelial cells, pulmonary edema, and hyaline membrane formation, and later by proliferative changes involving alveolar and bronchiolar lining cells, as well as interstitial cells. We recently experienced a patient who showed clinical, radiological and histological features of acute lung injury patterns without any identified etiologic agent.
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KEYWORD
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AIP(acute interstitial pneumonia), DAD(diffuse alveolar damage), fatal fulminant lung disease
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