• Title/Summary/Keyword: 간질성 폐렴

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Epidemic Pneumonia Caused by Mycoplasma Pneumoniae (유행성 마이코플라스마 폐렴에 대한 고찰)

  • Byun, Joo-Nam;Kim, Young-Chul
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.3
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    • pp.289-298
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    • 1994
  • Background: Most studies of Mycoplasma pneumonia involve a group of admitted patients in hospital, usually with major medical illness. So we investigated the epidemiologic and radiologic features during the course of outbreak of pneumonia in Chunnam coastal area. Methods: We retrospectively studied the epidemiologic and clinical feature of 105 patients with serologically proven Mycoplasma pneumonia treated at Kwang-Yang Hospital during a epidemic period of Jun.1993 to Dec.1993. All cases of pneumonia developed in this period were also reviewed and compared with serologically proven group. Results: 1) There were 63 males and 42 females. 2) More than half(57%) of cases belonged to 5-9 years of age group, and mean age was 6.5 years old. Mean age was steadily decreased as prevalence of Mycoplasma pneumonia had been subsided. 3) A major determinant of the outbreak seemed to be the population density rather than the population size. 4) The common radiologic features were interstitial in type, and 67 cases was restricted to one lobe. Lobar types are more common in late childhood, and interstitial or diffuse types in early childhood. Conclusion: These epidemiologic and radiographic characteristics would contribute to the diagnosis of Mycoplasma pneumonia.

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Thoracoscopic Lung Biopsy for Diffuse Interstitial Lung Disease (미만성 간질성 폐질환에서 흉강경폐생검)

  • Son, Dong-Seop;Jo, Dae-Yun;Yang, Ki-Min
    • Journal of Chest Surgery
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    • v.30 no.12
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    • pp.1232-1236
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    • 1997
  • Diffuse lung disease is amenable to diagnosis by means of clinical evaluation, bronchoalveolar lavage, transbronchial biopsy, and lung biopsy. The recently introduced technique of thoracoscopic wedge biopsy provides the potential advantages of greater selection of biopsy sites and reduced postoperative pain compared with those associated with standard open lung biopsy. Video assisted thoracoscopic lung biopsy was performed in 22 patients for the diagnosis of diffuse lung disease during the period from August 1994 to December 1996, and the following results were obtained: 1. The patients were 14 men and 8 women. The average age was 54.6 years. 2. 13 lung biopsy specimens were obtained from the right lower lobe, 4 from he right upper lobe, 3 from the right middle lobe, 3 from the left upper lobe, and 3 from the left lower lobe. 3. A comparison of pulmonary function tests between preoperative and postoperative values showed no significant differences in FVC, FEVI, and FEVl/FVC(p>0.05). All patients were pathologically diagnosed and the most common disease was usual interstitial pneumonia(8/22). In conclusion, thoracoscopic lung biopsy was a safe and effective diagnostic method of diffuse lung disease.

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A Case of Acute Interstitial Pneumonia with Invasive Pulmonary Aspergillosis (침습성 폐 아스페르길루스증을 동반한 급성 간질성 폐렴 1예)

  • Lee, Young-Min;Yoon, Hye-Kyoung;Kim, Joo-In
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.1
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    • pp.62-69
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    • 2002
  • Acute interstitial pneumonia (AIP) is a rare fulminant form of lung injury that presents acutely; usually in a previously healthy individual. It corresponds to a subset of cases of idiopathic adult respiratory distress syndrome (ARDS). Invasive pulmonary aspergillosis is a disease occuring predominantly with defects in immunity such as hematologic malignancy, influenza infection, postchemotherapy, long-term corticosteroid treatment. Invasive aspergillosis has worse prognosis and most cases are diagnosed at postmortem autopsies. We experienced a case of acute interstitial pneumonia with an invasive aspergillosis during corticosteroid treatment. Acute interstitial pneumonia with invasive aspergillosis was diagnosed by an open lung biopsy using thoracoscopy, showing fungal hyphae with sepsis and an acute angle branching invasion of the lung tissue and blood vessels. The patient was treated with IV amphotericin-B, but died due to septic shock.

A Case of Imatinib-mesylate associated Hypersensitivity Pneumonitis (Imatinib-mesylate에 의한 과민성 폐렴 1예)

  • Lee, Jae Wong;Kim, Hye Jin;Kim, Kyu Jin;Shin, Kyeong Cheol;Hong, Yeong Hoon;Chung, Jin Hong;Lee, Kwan Ho
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.4
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    • pp.423-426
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    • 2005
  • Imatinib-mesylate (Gleevec, Glivec) is a protein-tyrosine kinase inhibitor that inhibits the Bcr-Abl tyrosine kinase created by the Philadelphia chromosome abnormality in CML. Imatinib is also used to treat patients with c-kit (CD 117)-positive unresectable tumors, or metastatic malignant gastrointestinal stromal tumors, or both. Imatinib is a welltolerated drug with few side effects. However, it has been associated with gastrointestinal irritation, fluid retention and edema, skin rashes, depigmentation, hepatotoxicity, hemorrhage, and hematological toxicity (anemia, neutropenia, and thrombocytopenia). In addition, imatinib has been associated with dyspnea and cough, which are mainly secondary to the pleural effusion and pulmonary edema, which represent local or general fluid retention. These events appear to be dose related and are more common encountered in the elderly. However, there has been no report of hypersensitivity pneumonitis associated with imatinib-mesylate in Korea. We report a case of 51-year old woman who developed hypersensitivity pneumonitis that might have been induced by imatinib-mesylate during the treatment of a gastrointestinal stromal tumor.

Clinicopathologic features of Acute Interstitial Pneumonia (급성 간질성 폐렴의 임상적 고찰)

  • Shim, Jae-Jeong;Park, Sang-Muyn;Lee, Sang-Hwa;Lee, Jin-Gu;Cho, Jae-Yun;Song, Gwan-Gyu;In, Kwang-Ho;Yoo, Se-Hwa;Kang, Kyung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.58-66
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    • 1995
  • Background: Acute interstitial pneumonia is a relatively rare form of interstitial pneumonia, since the vast majority of interstitial pneumonia have a more chronic course. It corresponds to the lesion described by Hamman and Rich, as Hamman-Rich disease in 1944. Another name in the clinical literature is accelerated interstitial pneumonia, idiopathic acute respiratory distress syndrome (idiopathic ARDS), and the organizing stage of diffuse alveolar damage. Acute interstitial pneumonia differs from chronic interstitial pneumonia by clinical and pathologic features. Clinically, this disease is characterized by a sudden onset and a rapid course, and reversible disease. Method and Purpose: Five cases of pathologically proven acute interstitial pneumonia were retrospectively studied to define the clinical, radiologic, and pathologic features. Results: 1) The five cases ranged in age from 31 to 77 years old. The onset of illness was acute in all patients, it began with viral-like prodrome 6~40 days prior to shortness of breath, and respiratory failure eventually developed in all patients. In 2 cases, generalized skin rash was accompanied with flu-like symptoms. Etiologic agent could not be identified in any case. 2) All patients had leukocytosis and severe hypoxemia. Pulmonary function test of 3 available cases shows restrictive ventilatory defect, and one survived patient(case 5) has a complete improvement of pulmonary function after dismissal. 3) Diffuse bilateral chest infiltrates were present radiologically. Theses were the ground-glass, consolidation, and reticular densities without honeycomb fibrosis in all patients. The pathologic abnormalities were the presence of increased numbers of macrophages and the formation of hyaline membranes within alveolar spaces. There was also interstitial thickening with edema, proliferation of immature fibroblast, and hyperplasia of type II pneumocyte. In the survived patient(case5), pathologic findings were relatively early stage of acute interstitial pneumonia, such as hyaline membrane with mild interstitial fibrosis. 4) Of the 5 patients, four patients died of respiratory failure 14~90 days after onset of first symptom, and one survived and recovered in symptoms, chest X ray, and pulmonary function test Conclusion: These results emphasize that acute interstitial pneumonia is clinically, radiologically, and pathologically distinct form of interstitial pneumonia and should be separated from the group of chronic interstitial pneumonia. Further studies will be needed to evaluate the pathogenesis and the treatment of acute interstitial pneumonia.

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A Case of Interstitial Pneumonitis in a Patient with Rheumatoid Arthritis Treated with Leflunomide (Leflunomide로 치료중인 류마티스 관절염 환자에서 발생한 간질성 폐렴 1예)

  • Shin, Ah-Young;Kim, Seung Soo;Kim, Kyung Hee;Ju, Il-Nam;Ko, Hyeok Jae
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.477-481
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    • 2009
  • Leflunomide, a disease-modifying antirheumatic drug (DMARD) for the treatment of rheumatoid arthritis has been available in Korea since 2003. Leflunomide-associated interstitial pneumonitis has been appearing recently. A 25-year-old woman with a 12-month history of seronegative rheumatoid arthritis (RA) presented with acute respiratory insufficiency. She developed fever, dyspnea, and non-productive cough. Her medication history included methotrexate (15 mg/week. commencing 1 year prior) and leflunomide (20 mg/day, no loading dose, commencing 4 months prior). She was diagnosed with leflunomide-associated interstitial pneumonitis based on history, physical examination, laboratory and radiologic findings. She recovered quickly after leflunomide was withdrawn and steroids and cholestyramine were initiated quickly. We report a case of leflunomide-associated interstitial pneumonitis treated successfully with intravenous high-dose steroid and cholestyramine.

A Case of Acute Intersitial Pneumonia (급성 간질성 폐렴 1예)

  • Ahn, Young-Soo;Rha, Dong-Jib;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Kim, Yong-Hoon;Park, Choon-Sik;Park, Jae-Soung;Choi, Deuk-Lin;Jin, So-Young;Lee, Dong-Wha
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.6
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    • pp.719-724
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    • 1993
  • There is a small portion of interstitial pneumonia which presents acute respiratory failure developing within several days. The course of illness is short and most patients die within weeks or months. This type of interstitial pneumonia has been variously termed Hamman-Rich syndrome, accelerated interstitial pneumonia, or the organizing stage of diffuse alveolar damage. We experienced a case of acute interstitial pneumonia in 42-year old female who showed clinical, radiological and histologic features of acute interstitial pneumonia without any identified etiologic agent.

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Nationwide surveillance of acute interstitial pneumonia in Korea (급성 간질성 폐렴의 전국적 현황 조사)

  • Kim, Byoung-Ju;Kim, Han-A;Song, Young-Hwa;Yu, Jinho;Kim, Seonguk;Park, Seong Jong;Kim, Kyung Won;Kim, Kyu-Earn;Kim, Dong Soo;Park, June Dong;Ahn, Kang Mo;Kim, Hyo-Bin;Jung, Hyang-Min;Kang, Chun;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.324-329
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    • 2009
  • Purpose : Acute interstitial pneumonia (AIP) is a rare disease, but its prognosis is fatal because of lack of efficient treatment modality. Recently, it has been reported that there was epidemic AIP in Korea. This study aims to investigate the past and current status of AIP in Korea. Methods : We performed a nationwide survey and a prospective study. From August 6 to 15, 2008, a questionnaire survey was conducted to identify the prevalence, local distribution, and response to current treatments. The questionnaire was answered by pediatrician working in 23 referral centers in Korea. In addition, 5 referral centers in Seoul performed a preliminary prospective observational study by obtaining clinical data and specimens from appropriate patients. The Korea Centers for Disease Control and Prevention analyzed the samples for possible pathogens. Results : The survey showed 78 AIP cases had occurred and 36 patients had died. Lung biopsy was performed only on 20 patients. In 2008, 9 AIP cases developed. In a prospective study, 9 (M:F=5:4) patients developed AIP in spring and 7 (78%) died, with the mean rate of death occurring 46 days after diagnosis. Human corona virus 229E, cytomegalovirus, influenza A virus, influenza B virus, and parainfluenza virus were isolated from the respiratory specimens. Conclusion : This study showed nationwide prevalence of AIP in Korea. In addition, because of the high mortality rate and rapid progress, pediatricians need to be aware of the disease. Further studies and a nationwide network are required for reducing the morbidity and mortality rates related to AIP.