Acute interstitial pneumonitisacute interstitial pneumonitis, acute interstitial pneumonitis prognosis
Acute interstitial pneumonitis also known as acute interstitial pneumonia or Hamman–Rich syndrome is a rare, severe lung disease that usually affects otherwise healthy individuals There is no known cause or cure
Acute interstitial pneumonitis is often categorized as both an interstitial lung disease and a form of acute respiratory distress syndrome ARDS but it is distinguished from the chronic forms of interstitial pneumonia such as idiopathic pulmonary fibrosis1
- 1 Symptoms
- 2 Diagnosis
- 3 Treatment
- 4 Epidemiology
- 5 Prognosis
- 6 History
- 7 References
- 8 External links
The most common symptoms of acute interstitial pneumonitis are highly productive cough with expectoration of thick mucus, fever, and difficulties breathing These often occur over a period of one to two weeks before medical attention is sought The presence of fluid means the person experiences a feeling similar to 'drowning' Difficulties breathing can quickly progress to an inability to breathe without support respiratory failure
Acute interstitial pneumonitis typically progresses rapidly, with hospitalization and mechanical ventilation often required only days to weeks after initial symptoms of cough, fever, and difficulties breathing develop
Rapid progression from initial symptoms to respiratory failure is a key feature An x-ray that shows ARDS is necessary for diagnosis fluid in the small air sacs alveoli in both lungs In addition, a biopsy of the lung that shows organizing diffuse alveolar damage is required for diagnosis Other diagnostic tests are useful in excluding other similar conditions, but history, x-ray, and biopsy are essential These other tests may include basic blood work, blood cultures, and bronchoalveolar lavage The clinical picture is similar to ARDS, but AIP differs from ARDS in that the cause for AIP is not known
Treatment is primarily supportive Management in an intensive care unit is required and the need for mechanical ventilation is common Therapy with corticosteroids is generally attempted, though their usefulness has not been established The only treatment that has met with success to date is a lung transplant
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
Sixty percent of people with acute interstitial pneumonitis will die in the first six months of illness2 The median survival is 1½ months
However, most people who have one episode do not have a second People who survive often recover lung function completely
Acute interstitial pneumonitis was first described in 1935 by Louis Hamman and Arnold Rich, and given the name Hamman–Rich syndrome3
- ^ Hamman L; Rich AR 1944 "Acute diffuse interstitial fibrosis of the lungs" Bull Johns Hopkins Hosp 74: 177–212
- ^ Bouros, D; Nicholson AC; Polychronopoulos V; du Bois RM 2000 "Acute interstitial pneumonia" Eur Respir J 15 2: 412–8 PMID 10706513 doi:101034/j1399-3003200015b31x
- ^ Hamman, L; Rich AR 1935 "Fulminating diffuse interstitial fibrosis of the lungs" Transactions of the American Clinical and Climatological Association European Respiratory Society 51: 154–163
- synd/3010 at Who Named It
- 00181 at CHORUS
|Lower RT/lung disease
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