Presentation
A 15-year-previously-healthy male boy presented to the Hospital with a 6-day history of malaise, fever and cough. [ncbi.nlm.nih.gov]
We report a case of anti-synthetase syndrome presenting as acute interstitial pneumonia (AIP). CASE PRESENTATION We present the case of a 42-year-old school teacher of Malaysian origin. She was an ex-smoker. [academic.oup.com]
Fever is present in almost half of the patients on presentation and a history of viral-like symptomatology exists in most cases but extensive investigations for bacterial and viral agents are negative. [orpha.net]
Entire Body System
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Fatigue
On admission, the patient complained of general fatigue and dyspnoea. No finger‐clubbing, peripheral cyanosis, heart murmur or lymphadenopathy were noted, but fine crackles were audible over both sides of the chest. [academic.oup.com]
We describe a 51-year-old woman who was admitted to hospital because of cough and expectoration accompanied with general fatigue and progressive dyspnea. [hindawi.com]
A person may have these symptoms: A dry cough Shortness of breath, which may occur after effort or become worse over time Difficult or labored breathing Fatigue Clubbing, or enlargement of the fingertips at the base of the nails. [my.clevelandclinic.org]
[…] legionellosis) Alveolar filling disease Hypersensitivity reactions Connective tissue disorders Bronchoalveolar carcinoma References:[1][2][3] Clinical features Main symptoms Exertional dyspnea that progresses to dyspnea at rest Persistent nonproductive cough Fatigue [amboss.com]
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Intermittent Fever
One week after the commencement of tamoxifen she noted increasing dyspnea, cough, and intermittent fever. X-ray chest showed bilateral lung infiltrates. She was hospitalized and treated with broad spectrum antibiotic. [ascopubs.org]
Cardiovascular
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Heart Murmur
No finger‐clubbing, peripheral cyanosis, heart murmur or lymphadenopathy were noted, but fine crackles were audible over both sides of the chest. [academic.oup.com]
Musculoskeletal
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Joint Deformity
There was no skin rash, joint deformity, hepatosplenomegaly, or lymphadenopathy. Blood gas analysis revealed Po2 8.54 KPa, Pco2 4.9 KPa, pH 7.421, FiO2/PaO2 120. WBCs and HGB were within normal limits. NEU% of 74.1% was slightly increased. [hindawi.com]
Skin
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Chronic Dermatitis
Skin biopsy confirmed psoriasiform erythroderma with chronic dermatitis. HRCT done 4 weeks later showed complete resolution of the previous findings. [jfmpc.com]
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Hyperkeratosis
Our patient had an atypical presentation of anti-synthetase syndrome; she lacked evidence of Raynaud phenomenon, hyperkeratosis and arthritis. She also developed the less commonly associated ILD pattern, AIP. [academic.oup.com]
Workup
Case Presentation A 51-year-old woman, nonsmoker, without underlying diseases, no suspicious case history was admitted to the hospital for further workup of symptoms of cough, expectoration, and progressive dyspnea. [hindawi.com]
Initial workup revealed ground-glass opacities on computed tomography (CT) scan of the chest. Cardiac workup was unrevealing with a normal myocardial perfusion stress test. [ncbi.nlm.nih.gov]
[…] can also be found in other diseases such as CTDs, which is another ILD classification, but is idiopathic when the cause is unknown despite a comprehensive workup. [consultant360.com]
[…] often needed to make a diagnosis, with pertinent information and expertise contributed by the pulmonologist, radiologist and pathologist. 4 High-resolution CT should be obtained in virtually all patients with a suspected ILD. 4 Additional diagnostic workup [appliedradiology.com]
BAL cell count and differential may be useful in the diagnostic workup of the hospitalized patient with ILD. [bmcmedicine.biomedcentral.com]
X-Ray
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Left Pleural Effusion
There is a small left pleural effusion. CXR Suboptimal aspiration with small volume lungs. There is consolidation in the right mid zone and left lower lobe. Small bilateral pleural effusions are present. [ncbi.nlm.nih.gov]
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Pulmonary Consolidation
IPF의 급성 악화 시에는 HRCT상 기존의 망상음영과 벌집모양의 병변에 더하여 젖빛유리음영과 폐경화(pulmonary consolidation)의 소견이 미만성, 다국소성, 혹은 주변부 등의 분포로 나타나게 된다[12]. [ekjm.org]
Treatment
Acute interstitial pneumonia showing a marked reduction in lung capacity Treatment[edit] Treatment is primarily supportive. Management in an intensive care unit is required and the need for mechanical ventilation is common. [en.wikipedia.org]
This report describes a case of MDS in a patient who developed fatal acute interstitial pneumonitis (AIP) after the first seven-day course of intravenous azacitidine (75 mg/m(2)/day) treatment. [ncbi.nlm.nih.gov]
The lack of reports describing the use of CyA for the treatment of RA‐associated AIP warrants caution in its use; nevertheless, in our opinion, the poor prognosis of this complication of RA justifies treatment with this agent. Fig. 1. [academic.oup.com]
Management and treatment There is no proven treatment, however high-dose corticosteroids and cyclophosphamide are the drugs usually used. Prognosis The prognosis is severe and early mortality is high. [orpha.net]
Prognosis
Unfortunately, patients with polymyositis/dermatomyositis associated with pulmonary complications have a worse prognosis than patients with isolated forms. [ncbi.nlm.nih.gov]
It has a grave prognosis with 70% mortality in 3 months, despite mechanical ventilation. This review aims to clarify the relative clinical and pathological issues and terminology. [erj.ersjournals.com]
Prognosis The prognosis is severe and early mortality is high. The documents contained in this web site are presented for information purposes only. [orpha.net]
Prognosis depends on the histopathology findings and the specific form of interstitial lung disease and its response to therapy, which consists of high-dose steroids and immunomodulating agents. [rc.rcjournal.com]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
[…] specific etiologic agent or inciting event. [emedicine.medscape.com]
Katzenstein reserves the term AIP for those cases where there is no identifiable underlying etiology (such as sepsis). [histopathology-india.net]
Infectious etiology was excluded on the basis of microbiological investigations. [hindawi.com]
Epidemiology
Epidemiology[edit] Acute interstitial pneumonitis occurs most frequently among people older than forty years old. It affects men and women equally. There are no known risk factors; in particular, smoking is not associated with increased risk. [en.wikipedia.org]
Summary Epidemiology Prevalence of Acute interstitial pneumonia (AIP) is estimated at 1 in 25,000. Clinical description AIP occurs over a wide age range, with a mean age of approximately 50 years. [orpha.net]
Many questions still linger regarding the epidemiology, pathogenesis, and outcome. [thieme-connect.com]
Extremely rare (no conclusive epidemiological data available) Mean age 50 years but can occur at any age (7 - 83 years) (Eur Respir J 2000;15:412) No sex predilection Sites Bilateral lung, usually in all five lobes of the lung Pathophysiology Both endothelial [pathologyoutlines.com]
Pathophysiology
We describe the case of a fulminant form of AIP and discuss the pathophysiological mechanisms of AIP with reference to the histological pattern. [ncbi.nlm.nih.gov]
[…] alveolar damage Epidemiology Extremely rare (no conclusive epidemiological data available) Mean age 50 years but can occur at any age (7 - 83 years) (Eur Respir J 2000;15:412) No sex predilection Sites Bilateral lung, usually in all five lobes of the lung Pathophysiology [pathologyoutlines.com]
Pathophysiology [ edit ] Macklin described the pathophysiology of Hamman's syndrome to be barotrauma, whereby rupture of alveolar membranes causes a positive pressure gradient of air from the lungs into the mediastinum (the Macklin effect). [3] Diagnosis [en.wikipedia.org]
In this report, we present a case of a mid-age female with AIPwho, though treated with intensive physical and pharmacologic care, still displayed a rapid progressive pathophysiologic process, and eventually died of respiratory failure. 2. [hindawi.com]
Eosinophilic pneumonia Eosinophilic pneumonia is similar to organizing pneumonia in pathophysiology, but is mediated instead by an inappropriate increase in the number of eosinophils and macrophages in alveoli. [appliedradiology.com]
Prevention
Further study to identify causal factors is required in the hope of preventing morbidity and mortality related to this disease. [ncbi.nlm.nih.gov]
[…] of Medicine (JSV, KKB, RMC), National Jewish Medical and Research Center; Department of Pathology (CDC); Division of Pulmonary Sciences and Critical Care Medicine (MIS), University of Colorado Health Sciences Center, Denver, Colorado; Department of Preventive [journals.lww.com]
After a few days of adjuvant therapy with temozolomide and prophylaxis with trimetrophin-sulfamethoxazolo to prevent Pneumocystis Jiroveci, she had progressive and rapid worsening of symptoms with weakness, dyspnea and orthopnea. [currentdrugsafety.com]
To effectively follow up patients treated with gefitinib and to prevent deaths from gefitinib-induced lung injury, early recognition and intervention may prevent a fatal outcome, corticosteroids and non-invasive BIPAP-ventilation should be considered [jtd.amegroups.com]