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Query: UMLS:C0206061 (interstitial pneumonia)
 6,105 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Chronic pulmonary histoplasmosis is best regarded as an opportunist or saprophytic infection of abnormal pulmonary spaces by a fungus of very low human pathogenicity. Tissue disease results from host immune response to dispersions of soluble antigen from these focal sources. There are two distinct types of clinical and radiological response. One is an acute or subacute illness manifested by often large segmental pneumonic lesions which tend to heal and are designated as early lesions. The other, usually developing as a complication of the first, is a chronic disease marked by persistent cavitation, low gard chronic illness, and a tendency to promote pulmonary fibrosis and often progressive pulmonary insufficiency. The early lesion is a segmental interstitial pneumonitis with central areas of infarct-like necrosis often adjacent to bullous disease and often outlining prominent emphysematous spaces which appear as radiolucencies. These radiological findings are further characterized by early clearing of the interstitial components, infarct-like contraction of the necrotic zones, obliteration of much of the contained emphysematous and bullous spaces, and healing attended by considerable loss of lung volume. Symptoms are variable but tend to be mild. Malaise, fatigability, low-grade fever, aching chest pain and mild cough lasting a few days to a few weeks are usual. Symptoms are ameliorated by rest. Rest and diminished activity are recommended as treatment. Under these circumstances, 80% of early lesions heal completely and probably most of these would heal spontaneously. Any subsequent course of the disease depends on whether or nor large air spaces, adjacent to or contained within the area of pneumonitis, become infected and persist as cavities. This occurs in 20% of early lesions. Once established, an infected cavity tends to persist and to be attended by symptoms of chronic bronchitis with chronic cough and sputum, fatigability, anorexia, and weight loss. Persisting thickwalled cavities often induce gradual development of pulmonary fibrosis, particulary in the lung bases, apparently from aspiration of antigenic material. This and the accelerated obstructive bronchopulmonary disease often lead to progressive pulmonary insufficiency. The use of amphotericin B is recommended for all persistent thick-walled cavities and in some circumstances surgical resection may be indicated.
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PMID:Chronic pulmonary histoplasmosis. 79 26

A 72-year-old female with malignant lymphoma, receiving oral cyclophosphamide (CPA) and prednisone, developed severe pulmonary insufficiency 56 days after the start of CPA (total dosages 8.5 g). A chest roentgenogram showed a diffuse interstitial shadow throughout both lungs, and CT scan revealed increased density, most prominent in the central zones, and a thickening of bronchovascular bundles. She was diagnosed from the clinical course and the postmortem examination as having cyclophosphamide-induced interstitial pneumonia. Interstitial pneumonia as a side-effect of cyclophosphamide is very rare in Japan. The clinical and pathological findings in this case and a review of the literature on 38 other cases world-wide are reported.
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PMID:[An autopsy case of cyclophophamide-induced interstitial pneumonia]. 207 9

Two middle-aged women showed typical erythematous heliotrope eruption and Gottron's sign without any symptom of myositis. The patients were diagnosed as 'amyopathic dermatomyositis' because of normal serum CPK levels, normal EMG and no histological abnormality by muscle biopsy. Clinical manifestations improved by the treatment with corticosteroids. During tapering of corticosteroids, however, intersititial pneumonitis developed and rapidly progressed. The first patients was treated with methylprednisolone pulse therapy, azathiopurine and methotrexate. The second patients was treated with betamethazone, methlprednisolone pulse therapy and cyclosporin A. In spite of these extensive immunosuppressive therapies, both patients died of pulmonary insufficiency a few months after admission. In the literature there has been only several cases of amyopathic dermatomyositis and only one case with fatal rapidly progressive interstitial pneumonitis. A new approach to the treatment of this disease should be made.
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PMID:[Two cases of amyopathic dermatomyositis with fatal rapidly progressive interstitial pneumonitis]. 224 55

A desquamative, interstitial pneumonitis was diagnosed histologically in a 9-month-old boy who first became ill at the age of 5 weeks. The desquamative interstitial pneumonitis was associated with an acquired cytomegalovirus (CMV) infection. Despite treatment with corticoids, acyclovir and artificial ventilation, the patient died of pulmonary insufficiency at the age of 15 months. The autopsy revealed an alveolar lipoproteinosis.
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PMID:Desquamative interstitial pneumonitis and alveolar lipoproteinosis: diagnostic difficulties and therapy problems with an infant. 302 10

A special type of respiratory distress syndrome has been described in connection with fractures of the long bones, called fat embolism syndrome. In addition to the respiratory signs - tachypnoea, hypoxaemia and snow storm infiltrations in the chest x-ray films- the syndrome consists of petechiae, thrombocytopenia, cerebral disturbances, pyrexia etc. The respiratory insufficiency in this syndrome may be explained by a coagulation disorder, in which the release of tissue thromboplastins from the traumatized tissues results in an interstitial pneumonitis and peripheral thrombocytopenia. Accumulation of fat in the lung microvasculature has been observed both clinically and post morten. The importance of fat for the pathogenesis of the syndrome is not clear, but fat globuli are present in quantities, which are not encountered in other types of post-traumatic pulmonary insufficiency. Careful observation of a patient with multiple fractures is the cornerstone of early diagnosis. Cautions handling and early stabilization of fractures reduce the tissue trauma and may thus reduce the manifestations of the fat embolism syndrome. Respiratory assistance is given when necessary, and most often the syndrome is self-resolving. Fulminant cases with increasing symptomatology are treated with methylprednisolone and respirator.
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PMID:Fat embolism syndrome: etiology, pathogenesis and treatment. 693

Intestinal lymphoid hyperplasia and recurrent pulmonary infections by pyogenic bacteria are well-recognized accompaniments of common variable (late onset) hypogammaglobulinemia. A 35-yr-old woman with this illness had progressive pulmonary insufficiency caused by nodular lymphoid interstitial pneumonitis, rather than by infectious lung damage, and intestinal lymphoid nodular hyperplasia. B cells were abundant in the intestinal nodules but absent in the pulmonary nodules by immunoperoxidase staining. Pulmonary lymphocytes isolated in single-cell suspension from the biopsy were 0.5% B cells and 82% T cells. Prednisone therapy improved pulmonary function and decreased the intestinal lymphoid nodules. Lymphocytic interstitial pneumonitis should be considered in patients with hypogammaglobulinemia and restrictive lung disease.
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PMID:Common variable hypogammaglobulinemia with T-cell nodular lymphoid interstitial pneumonitis and B-cell nodular lymphoid hyperplasia: different lymphocyte populations with a similar response to prednisone therapy. 698 62

A 3-year-old HIV-positive boy developed Pneumocystis carinii pneumonia (PCP) resulting in chronic interstitial pulmonary disease, which persisted for the following 3 years; he was essentially asymptomatic and the lung findings had therefore been attributed to lymphocytic interstitial pneumonia (LIP). He subsequently developed extensive cystic pulmonary disease, documented by CT, leading to recurrent pneumothorax and severe pulmonary insufficiency. Lung biopsy revealed chronic PCP infection associated with extensive pulmonary fibrosis and calcification. This case suggests that Pneumocystis carinii may cause chronic progressive pulmonary fibrosis with cyst formation and respiratory failure.
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PMID:Severe cystic pulmonary disease associated with chronic Pneumocystis carinii infection in a child with AIDS. 772 92

A 45-year-old Japanese woman presented with a high fever, a nonproductive coughing, and severe dyspnea, and was admitted to another hospital. During the week prior to hospitalization, she had been given Shosaikoto for treatment of liver dysfunction of unknown etiology. Mycoplasma pneumonitis was initially suspected, so she was treated with antibiotics (clindamycin and minocycline) and received oxygen therapy. Pulmonary insufficiency worsened rapidly, and she was transferred to our hospital. On admission, a chest roentgenogram revealed bilateral alveolar infiltrates predominantly in the medial lung fields. Furosemide and high-dose methylprednisolone were immediately administered, but hypoxemia increased. When the PaO2 was 55.7 Torr while the patient breathed 100% oxygen, mechanical ventilation with positive end-expiratory pressure (PEEP) was started. Arterial blood-gas values improved dramatically, and the chest roentgenogram became clear. Our diagnosis of noncardiogenic pulmonary edema is based on the chest-roentgenographic findings, infiltration of inflammatory cells as seen in two lung-biopsy specimens and bronchoalveolar lavage fluid, the lack of findings of heart failure on physical examination and electrocardiography, and the good clinical response to PEEP. A positive lymphocyte stimulation test in response to Shosaikoto implicated this non-traditional herbal medicine as an etiologic factor in the non-cardiogenic pulmonary edema. Shosaikoto has been identified as the cause of interstitial pneumonia or eosinophilic pneumonia, but pulmonary edema associated with Shosaikoto has not been previously described. This case suggests that methylprednisolone treatment may be insufficient for Shosaikoto-induced pulmonary edema, and that mechanical ventilation with PEEP is very effective.
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PMID:[Pulmonary edema associated with the Chinese medicine shosaikoto]. 986 80

We present the circumstances surrounding a 57-year-old Caucasian man with advanced colorectal cancer who developed relapsing interstitial lung disease following a single exposure to irinotecan (CPT-11). Progressive pulmonary insufficiency and death were reported in the initial Japanese studies, despite institution of empiric steroid therapy for a syndrome similar to that which our patient experienced. As a result, patients with compromised pulmonary function were generally excluded from US clinical trials. Notwithstanding this, cough and dyspnea were reported in approximately 20% of patients in the US studies. As the clinical indications for the use of this agent expand, we describe irinotecan-associated interstitial pneumonitis as a serious potential adverse effect. Patients with pre-existing pulmonary disease may be at higher risk for this complication and clinicians should be alert to this possibility.
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PMID:Irinotecan-associated pulmonary toxicity. 1112 33