Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Asymptomatic, Localized, and Idiopathic Diffuse Alveolar Damage

  • Jeon, Young-Do (Department of Internal Medicine, National Medical Center) ;
  • Hong, Christian (Department of Immunology, National Medical Center) ;
  • Joh, Joon-Sung (Department of Internal Medicine, National Medical Center) ;
  • Jung, Ja-Young (Department of Internal Medicine, National Medical Center) ;
  • Min, Ji-Won (Department of Internal Medicine, National Medical Center) ;
  • Park, Seon-Young (Department of Internal Medicine, National Medical Center) ;
  • Lee, Ga-Ram (Department of Internal Medicine, National Medical Center)
  • Received : 2011.12.29
  • Accepted : 2012.02.06
  • Published : 2012.04.30
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Abstract

Diffuse alveolar damage (DAD) is a histological change in lung tissue, and is generally caused by an acute lung injury, which is characterized by bilateral and widespread damages. Localized DAD occurs very rarely. The causes for DAD are numerous, but the chief cause is acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia, in cases of idiopathic manifestation. The 82-year-old patient, in this case study, showed a DAD lesion in only 1 lobe. The patient was otherwise healthy, with no previous symptoms of DAD. He was admitted to our medical center owing to localized infiltration, observed on his chest radiograph. Laboratory studies showed no signs of infections. DAD was confirmed by a surgical lung biopsy. The patient received corticosteroid treatment and had gradually improved. We report the case of a patient with localized, idiopathic DAD that cannot be classified as acute interstitial pneumonia or acute exacerbation of idiopathic interstitial pneumonia.

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References

  1. Kaarteenaho R, Kinnula VL. Diffuse alveolar damage: a common phenomenon in progressive interstitial lung disorders. Pulm Med 2011;2011:531302.
  2. Gill JR, Sheng ZM, Ely SF, Guinee DG, Beasley MB, Suh J, et al. Pulmonary pathologic findings of fatal 2009 pandemic influenza A/H1N1 viral infections. Arch Pathol Lab Med 2010;134:235-43.
  3. Yazdy AM, Tomashefski JF Jr, Yagan R, Kleinerman J. Regional alveolar damage (RAD): a localized counterpart of diffuse alveolar damage. Am J Clin Pathol 1989; 92:10-5. https://doi.org/10.1093/ajcp/92.1.10
  4. Castro CY. ARDS and diffuse alveolar damage: a pathologist's perspective. Semin Thorac Cardiovasc Surg 2006;18:13-9. https://doi.org/10.1053/j.semtcvs.2006.02.001
  5. Collard HR, Moore BB, Flaherty KR, Brown KK, Kaner RJ, King TE Jr, et al. Acute exacerbations of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2007; 176:636-43. https://doi.org/10.1164/rccm.200703-463PP
  6. Akira M, Kozuka T, Yamamoto S, Sakatani M. Computed tomography findings in acute exacerbation of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 2008;178:372-8. https://doi.org/10.1164/rccm.200709-1365OC
  7. King TE Jr. Chapter 255. Interstitial lung disease. In: Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al., editors. Harrison's principles of internal medicine. 17th ed. New York: McGraw-Hill Co, Inc.; 2008. p. 1643-51.
  8. Sakamoto K, Taniguchi H, Kondoh Y, Ono K, Hasegawa Y, Kitaichi M. Acute exacerbation of idiopathic pulmonary fibrosis as the initial presentation of the disease. Eur Respir Rev 2009;18:129-32. https://doi.org/10.1183/09059180.00000409
  9. Suh GY, Kang EH, Chung MP, Lee KS, Han J, Kitaichi M, et al. Early intervention can improve clinical outcome of acute interstitial pneumonia. Chest 2006;129: 753-61. https://doi.org/10.1378/chest.129.3.753
  10. Papazian L, Doddoli C, Chetaille B, Gernez Y, Thirion X, Roch A, et al. A contributive result of open-lung biopsy improves survival in acute respiratory distress syndrome patients. Crit Care Med 2007;35:755-62. https://doi.org/10.1097/01.CCM.0000257325.88144.30