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]

Presented herein is a case of a previously healthy 64-year-old woman withou… PMC Free Full TextPMC Free PDF Primary Sjogren's Syndrome Presenting as Acute Interstitial Pneumonitis/Hamman-Rich Syndrome. [unboundmedicine.com]

• Fever

  Minor ailments, such as common colds without fever, are taken care of at the medical adviser's office or in the offices of practicing physicians of the town. [jamanetwork.com]

  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]

  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. [en.wikipedia.org]

• Pain

  Issues Specialties Addiction Medicine Cardiology Dermatology Diabetes Endocrinology Gastroenterology Geriatrics Hematology Hepatology Hospice & Palliative Medicine Immunology Infectious Diseases Men's Health Mental Health Nephrology Neurology Oncology Pain [mdedge.com]

  … Ajmal F CR A previously well, 45-year-old Pakistani lady was admitted to the medical unit on-call of Khyber Teaching Hospital (KTH) Peshawar with a 5-day history of fever, productive cough with copious mucoid sputum, dyspnea, and pleuritic chest pain [unboundmedicine.com]

  As the disease progresses, weight loss, muscle and joint pain, and fatigue may also occur. [radiologyinfo.org]

  Patients with prominent, non-respiratory symptoms such as muscle pain, joint pain or thickening and tightness of the skin, fingers and toes may have interstitial lung disease caused by an underlying connective tissue disorder. [3] Treatment of Interstitial [inogen.com]

  Presenting symptoms can include: non-specific chest pain dyspnea dysphonia subfebrile temperature Interestingly, possible signs on clinical examination include the Hamman sign, a pulse-synchronous rasping sound which is believed to be caused by pneumopericardium [radiopaedia.org]

• Fatigue

  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]

  Signs and symptoms of chronic pneumonitis include: Shortness of breath Cough Fatigue Loss of appetite Unintentional weight loss When to call a doctor Call your doctor anytime you have difficulty breathing, no matter what might be the cause. [mayoclinic.org]

  Oxygen therapy Because many people with ILD have low levels of oxygen in their blood, oxygen therapy improves blood oxygen levels while reducing strain on the heart and lungs and improving breathlessness and fatigue. [5] Pulmonary rehabilitation A formal [inogen.com]

• Wound Infection

  The post operative course was complicated by wound infection treated with combination of clindamycin and ciprofloxacin. The patient was recommended adjuvant tamoxifen. Her other medication were metformin, valsartan, calcium and vitamin D. [ascopubs.org]

• Hodgkin Lymphoma

  Abstract Fourteen adult patients with haematological malignancies (eight non-Hodgkin's lymphoma, one multiple myeloma, one chronic lymphocytic leukaemia, two acute lymphoblastic leukaemia and two acute myeloid leukaemia) developed acute interstitial pneumonitis [ncbi.nlm.nih.gov]

• Pneumonia

  […] forms of interstitial pneumonia. [ncbi.nlm.nih.gov]

  […] failure, which is distinguishable from the other more chronic forms of interstitial pneumonia. [erj.ersjournals.com]

  Acute or subacute IIPs include acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), nonspecific interstitial pneumonia (NSIP), acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and AE-NSIP. … Publisher Full Text doi.orgdoi.org [unboundmedicine.com]

  English acute interstitial pneumonitis human disease acute interstitial pneumonia AIP Hamman-Rich disease Hamman-Rich syndrome Idiopathic pulmonary fibrosis, acute fatal form accelerated interstitial pneumonia acute interstitial pneumonitis, NOS acute [wikidata.org]

  Acute interstitial pneumonia (AIP), a form of idiopathic interstitial pneumonia, equally affects apparently healthy men and women, usually those > 40 years. [msdmanuals.com]

• Respiratory Distress

  respiratory distress syndrome in newborn (perinatal) (P22.0) idiopathic J84.114 respiratory distress acute J80 ICD-10-CM Diagnosis Code J80 Acute respiratory distress syndrome 2016 2017 2018 2019 2020 Billable/Specific Code Applicable To Acute respiratory [icd10data.com]

  PaO2/FIO2 ≤ 300 mm Hg is one of the diagnostic criteria of acute respiratory distress syndrome. [pathologyoutlines.com]

  The alveolar damage comprises three phases: an acute exudative phase a subsequent organizing phase a final fibrotic phase Histological features are very similar to those of adult respiratory distress syndrome (ARDS). [radiopaedia.org]

  AIP radiologically and physiologically resembles acute respiratory distress syndrome (ARDS) and is considered to represent the small subset of patients with idiopathic ARDS. [ncbi.nlm.nih.gov]

• Dyspnea

  Dyspnea progressed such that within 15 days it was triggered by minimal effort. The patient died 15 hours after admission to our hospital, with a clinical picture of adult respiratory distress. [archbronconeumol.org]

  Abstract We report a case of a previously healthy 41-year-old man who was admitted for progressive dyspnea and cough, which culminated in respiratory failure, shock, and death. [ncbi.nlm.nih.gov]

  For example, exertional dyspnea in ILD resembles dyspnea experienced by patients with more common ailments such as asthma, COPD, and heart disease. [consultant360.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]

  The main symptoms are exertional dyspnea and a dry cough. Bibasilar inspiratory crackles or rales are usually heard on auscultation. Treatment is based on the underlying cause. [amboss.com]

• Productive Cough

  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. [dixion-healthcare.com]

  cough with copious mucoid sputum, dyspnea, and pleuritic chest pain. [unboundmedicine.com]

  CASE 104 Clinical Presentation 50-year-old woman with persistent fever, progressive dyspnea, and non-productive cough for several weeks despite antibiotics for presumed community-acquired pneumonia Radiologic Findings Baseline frontal chest X-ray ( Fig [radiologykey.com]

  cough with expectoration of thick mucus, fever, and difficulties breathing. [en.wikipedia.org]

• Sputum

  Med 2016; 2016:4136765Khan A, Humayun M, … Ajmal F CR A previously well, 45-year-old Pakistani lady was admitted to the medical unit on-call of Khyber Teaching Hospital (KTH) Peshawar with a 5-day history of fever, productive cough with copious mucoid sputum [unboundmedicine.com]

  No organisms were isolated from blood and sputum cultures. Procalcitonin was within normal range at 0.16. Computerized tomography (CT) of thorax with contrast was performed (please see Fig. 1 A and B). [academic.oup.com]

  A good sputum specimen and appropriately interpreted Gram stain can be essential. [infectiousdiseaseadvisor.com]

  Chest CT imaging is almost always obtained in clinical practice. – Echocardiogram – Sputum, blood and urine cultures – Viral respiratory panel – Ventilation-perfusion lung scan – Other laboratory data: D-dimer, B-natriuretic peptide, cardiac enzymes – [clinicaladvisor.com]

  Sputum or culture of lung secretions with bronchoscopy. Serum precipitating antibodies against offending antigens for suspected hypersensitivity pneumonitis. [ 7 ] CXR: may be normal or show micronodular or reticular opacities. [patient.info]

• Chest Pain

  Presenting symptoms can include: non-specific chest pain dyspnea dysphonia subfebrile temperature Interestingly, possible signs on clinical examination include the Hamman sign, a pulse-synchronous rasping sound which is believed to be caused by pneumopericardium [radiopaedia.org]

  We present the case of a 61-year old male veteran with a history of nodular eczema who presented with 2 weeks of progressive dyspnoea on exertion and pleuritic chest pain. The patient was started on ustekinumab 5 weeks prior to presentation. [ncbi.nlm.nih.gov]

  Clinical manifestations Most commonly in individuals 20-50 years of age; associated with smoking Cough, dyspnea, chest pain. Pneumothorax (10-30%); rarely diabetes insipidus. [meddean.luc.edu]

  The most common presentation of MTXP is subacute onset of cough, dyspnea, chest pain, and crackles. Chest radiograph findings include combined alveolar and interstitial infiltrates. [jfmpc.com]

• Xerostomia

  For example, xerostomia in Sjörgen’s syndrome, lupus pernio and erythema nodosum for sarcoidosis, malar rash in systemic lupus erythematosus, rheumatoid nodules in rheumatoid arthritis, clubbing in idiopathic pulmonary fibrosis (IPF), and lymphangitic [consultant360.com]

• Erythema

  Palpitations, syncope, dysesthesias, erythema nodosum, and sore shins may be manifestations of sarcoidosis. [consultant360.com]

  His physical exam was significant for mild rales in the left lung base; circular, scaly, plaque-like rash on the right lower extremity inferior to the patella; and a 0.5 cm furuncle with surrounding erythema on the right medial mid-shin. [ncbi.nlm.nih.gov]

  Some manifestations to watch for: - Myocardial involvement (possible conduction disturbances) - Uveitis - Cranial nerve VII involvement - Erythema nodosa PFTs: Decreased volumes, compliance, DLCO, hypoxemia. [meddean.luc.edu]

  Loefgren's syndrome, an acute presentation of sarcoidosis, consists of arthritis, erythema nodosum, bilateral hilar adenopathy and occurs in 9-34% of patients. Erythema nodosum is seen predominantly in women and arthritis is more common in men. [radiologyassistant.nl]

• Dry Eyes

  She also complained of dry eyes, mouth, and vagina. [unboundmedicine.com]

  eyes, and dry mouth Exposure to toxic substances Exposure to the following substances at work or in the environment can cause lung scarring as well: animal proteins, such as from birds asbestos fibers coal dust grain dust mold silica dust tobacco smoke [healthline.com]

  Suspect a CTD if Musculosketetal pain Weakness Fatigue Joint pains and swelling Photosensitivity Raynauds phenomenon Pleuritis Dry eyes or mouth INTERSTITIAL LUNG DISEASE in CTD 14. [slideshare.net]

  EXTRAPULMONARY SYMPTOMS Do not overlook dry eyes and mouth (Sjögren’s syndrome), dysphagia (systemic sclerosis), or sinusitis with epistaxis (granulomatosis with polyangiitis, formerly known as Wegener's granulomatosis). [consultant360.com]

  Variables All Patients NSIP UIP P Age, y* 66, 62–71 64, 60–71 68, 66–71 0.16 (n = 33) (n = 22) (n = 11) Female 23 16 7 0.70 (n = 33) (n = 22) (n = 11) Never smoker 23 17 6 0.24 (n = 33) (n = 22) (n = 11) Dry eyes or dry mouth 29 19 10 1.00 (n = 31) (n [journals.plos.org]

• Suggestibility

  The myelin-like lamellate structures might suggest the degree of alveolar damage. [ncbi.nlm.nih.gov]

  A number of histopathological features may help suggest chronic HP as the aetiology. [err.ersjournals.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]

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]

[…] 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]

• Pulmonary Infiltrate

  We treated the patient with pulse steroid therapy, and improvement in respiratory function and decreased pulmonary infiltrations demonstrated good response to steroids use. [ncbi.nlm.nih.gov]

  A repeat chest radiograph revealed acute wide spread pulmonary infiltrates, which represented a significant change from the prior study (Figure 1). Diuretics were started with a presumptive diagnosis of congestive heart failure. [hindawi.com]

  Pulmonary interstitial infiltrates gradually resolved and a nearly complete resolution of pulmonar infiltrates was found 3 days after CRRT initiation. Arterial blood gas analysis was also found to be normal (Figures 2Band2C). [scielo.br]

• Bilateral Pulmonary Infiltrates

  In advanced disease, bilateral pulmonary infiltrates are the most salient abnormality. The lower lung lobes are more frequently involved, but an obvious apicobasal gradient, as seen in UIP, is usually missing (,3). [pubs.rsna.org]

• Candida

  However candida albicans was noted on mycology, which was thought to be likely a contaminant cause. Blood cultures and virology screen were also negative. However her (ANCA) perinuclear was mildly positive. [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]

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]

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]

Unfortunately, patients with polymyositis/dermatomyositis associated with pulmonary complications have a worse prognosis than patients with isolated forms. [ncbi.nlm.nih.gov]

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]

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 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]

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]

Clinical Information A group of interstitial lung diseases with no known etiology. There are several entities with varying patterns of inflammation and fibrosis. [icd9data.com]

Infectious etiology was excluded on the basis of microbiological investigations. [hindawi.com]

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]

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]

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]

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]

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]

[…] 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]

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]

[…] 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]

Further study to identify causal factors is required in the hope of preventing morbidity and mortality related to this disease. [ncbi.nlm.nih.gov]

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]

Getting a flu shot every year can help prevent both the flu and pneumonia. In addition, pneumococcal bacteria can cause minor problems such as ear infections. [cedars-sinai.edu]

Can interstitial lung disease be prevented? Interstitial lung disease can be prevented only to the extent that its individual causes may be prevented. [medicinenet.com]