• Title/Summary/Keyword: Lung diseases, interstitial

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A Case of Drug-Induced Interstitial Pneumonitis Caused by Valproic Acid for the Treatment of Seizure Disorders

  • Kim, Se Jin;Jhun, Byung Woo;Lee, Ji Eun;Kim, Kang;Choi, Hyeun Yong
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.3
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    • pp.145-148
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    • 2014
  • Valproic acid is one of the most common antiepileptic drugs used for the treatment of several seizure disorders. A 20-year-old man presented with a sudden decline of consciousness. He had a neurosurgery operation for intracranial and intraventricular hemorrhage. Following surgery, antiepileptic medication was administered to the patient in order to control his seizure events. On valproic acid treatment, he began to complain of fever and dyspnea. His symptoms persisted despite receiving empirical antibiotic treatment. All diagnostic tests for infectious causes were negative. A high-resolution computed tomography scan of the chest revealed predominantly dependent consolidation and ground-glass opacities in both lower lobes. The primary differential was drug associated with interstitial lung disease. Therefore, we discontinued valproic acid treatment and began methylprednisolone treatment. His symptoms and radiologic findings had significantly improved after receiving steroid therapy. We propose that clinicians should be made aware of the potential for valproic acid to induce lung injury.

A Case of Lymphocytic Interstitial Pneumonia (Lymphocγtic Interstitial Pneumonia 1예)

  • Suh, Yo-Ahn;Kim, Sang-It;Kim, Dae-Han;Kwak, Jin-Young;Lee, Jae-Cheol;Baek, Hee-Jong;Chung, Jin-Haeng
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.4
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    • pp.390-394
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    • 2001
  • Lymphocytic interstitial pneumonia(LIP) is characterized by a massive infiltration of the interstitium of the lung by mature lymphocytes, plasma cells and reticuloendothelial cells. LIP may be associated with autoimmune diseases including Sj$\check{o}$grens syndrome, SLE, myasthenia gravis, pernicious anemia, autoimmune hemolytic anemia, and HIV or an EB virus infection. There is a possibility of LIP progressing to a pulmonary or systemic lymphoma. The therapeutic response to corticosteroids and/or immunosuppressive drugs varies. Here we report a case of LIP that was diagnosed by an open lung biopsy and clonality study. The patient was a 36 year-old man without autoimmune disease or HIV infection. He was admitted as a result of severe hypoxemia showing $PaO_2$ of 48.3mmHg. The patient was treated with corticosteroids after the diagnosis and had fully recovered without a sequalae or relapse.

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Recurrent Erlotinib-Induced Interstitial Lung Disease on Non-Small Cell Lung Cancer

  • Park, Sang Don;Kim, Areum;Park, Jin-Seok;Shin, Chun Ho;Nam, Hae Sung;Kim, Lucia;Cho, Jae Wha;Ryu, Jeong Sun;Kwak, Seung Min
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.5
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    • pp.445-448
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    • 2009
  • Erlotinib ($Tarceva^{(R)}$) has been considered to be a new, promising oral chemotherapy agent for local advanced or metastatic non-small cell lung cancer (NSCLC). Erlotinib is regarded as relatively safe, but interstitial lung disease (ILD) related to erlotinib has been reported on an infrequent basis in Asia. We report an histologically confirmed case of recurrent erlotinib-induced ILD. Although, the patient was highly responsive to the first erlotinib treatment, the therapy was discontinued due to erlotinib-induced ILD. After intravenous high dose methylpredinisolone treatment, ILD was improved rapidly by radiologic studies, but the particular lung cancer re-emerged. We restarted the patient erlotinib on low-dose oral methylpredinisolone, resulting in a recurrence of erlotinib-induced ILD. Our case suggests that re-administration of erlotinib should be performed on a limited basis in patients that have developed ILD on previous use, even if a therapeutic effect can be estimated.

Update in Diagnosis of Idiopathic Pulmonary Fibrosis and Interstitial Lung Abnormality (특발폐섬유증 진단의 최신 지견과 간질성폐이상)

  • Bo Da Nam;Jung Hwa Hwang
    • Journal of the Korean Society of Radiology
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    • v.82 no.4
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    • pp.770-790
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    • 2021
  • Idiopathic pulmonary fibrosis (IPF), based on the 2018 international clinical practice guidelines, can be diagnosed with a usual interstitial pneumonia (UIP) pattern on high-resolution computed tomography (HRCT) and compatible clinical findings. Given that imaging is pivotal for IPF evaluation and diagnosis, more emphasis should be placed on the integration of clinical, radiological, and pathologic findings for multidisciplinary diagnosis. Interstitial lung abnormality (ILA), on the other hand, has a purely radiological definition based on the incidental identification of CT abnormalities. Taken together, differentiation between ILA and clinically significant interstitial lung disease (ILD) must be based on proper clinical evaluation. With this review, the recent updates in IPF diagnosis and the radiologic considerations for ILA can be well understood, which can be helpful for the proper diagnosis and management of patients with diffuse interstitial pulmonary fibrosis.

A Case of Interstitial Pneumonitis with Acute Live Injury Caused by Herbal Medicine Made from Golden Thread (황련으로 만든 한약 복용 후 발생한 급성 간손상을 동반한 간질성 폐렴 1예)

  • Jhun, Byung-Woo;Kim, Da-Min;Park, Ji-Hyeon;Jung, Hyun-Ae;Song, Lim-Hwa;Han, Joung-Ho;Chung, Man-Pyo
    • Tuberculosis and Respiratory Diseases
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    • v.71 no.6
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    • pp.470-475
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    • 2011
  • So far more than 350 drugs have been reported to be the cause for lung injury and the incidence tends to increase. Although infiltrative lung disease is the most common pattern of drug-induced lung injury, it can appear in the form of alveolar changes, vasculitis and other injury. Herbal medicine also has been known as a cause for interstitial pneumonitis, but it is difficult to identify the key herbal medicine because of the complex components of the contents. Till date, there is no report of pneumonitis caused by golden thread. Here we report a case of a 54-year-old male who developed interstitial pneumonitis with acute liver injury caused by herbal medicine made from golden thread.

Review of Humidifier Lung Cases Caused by Use of Humidifier - Focusing on Probable Environmental Causal Agents - (가습기 폐질환(Humidifier Lung)의 환경적 원인 인자 고찰)

  • Park, Donguk
    • Journal of Environmental Health Sciences
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    • v.39 no.2
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    • pp.105-116
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    • 2013
  • Background: In Korea, there is low awareness of the respiratory health problems caused by the use of humidifiers, leading to a lack of governmental measures. Objectives: The objectives of this study were to review cases of varying degrees of humidifier lung and fever in connection with the use of humidifiers and to summarize the probable environmental agents causing these cases. Methods: We searched all articles reporting on humidifier lung, humidifier fever, and humidifier diseases caused by the use of a humidifier both at home and in the workplace. Results: We summarized a number of cases of varying degrees of respiratory diseases resulting from inhalation of water mist of humidifiers containing various species of bacteria and fungi and their toxins. Type of respiratory disease connected with humidifier lung includes interstitial pneumonitis, hypersensitivity pneumonitis, fever and several respiratory symptoms. Non-tuberculous mycobacteria (NTM), Actinomycetes, endotoxins and contaminated humidifier water were the most commonly suspected probable environmental agents causing humidifier lung. In Korea, the use of humidifier biocide is suspected as a likely cause of fatal lung injury including death and lung transplantation. Conclusion: Governmental policy should be devised and measures including a national surveillance system should be taken to prevent humidifier lung caused by the use of humidifiers.

A Case of Bronchiolitis Interstitial Pneumonitis (Bronchiolitis Interstitial Pneumonitis 1예)

  • Chi, Su Young;Ryu, Kyoung Ho;Lim, Dae Hun;Shin, Hong-Joon;Ban, Hee Jung;Oh, In-Jae;Kwon, Yong Soo;Kim, Kyu-Sik;Lim, Sung-Chul;Kim, Young-Chul;Choi, Yoo-Duk;Song, Sang-Yun;Seon, Hyun Ju
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.4
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    • pp.364-368
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    • 2009
  • Bronchiolitis interstitial pneumonitis (BIP), an unclassified and newly described interstitial pneumonia, has a combined feature of prominent bronchiolitis, interstitial inflammation, and fibrosis. It is distinct from bronchiolitis obliterans or bronchiolitis obliterans organizing pneumonia (BOOP). BIP has a better prognosis than common cases of interstitial pneumonia. However, BIP has a poorer prognosis than BOOP. BIP's response to corticosteroids is not as successful as BOOP's response to this treatment. We encountered the case of a 31-year-old woman with BIP with an initial presentation of dyspnea and a cough that had lasted for 3 months. The patient's chest CT scan demonstrated patchy ground glass opacities and multiple ill-defined centrilobular nodules in both lungs, suggesting military tuberculosis or nontuberculous mycobacterial infection. A video-assisted thoracoscopic lung biopsy resulted in the diagnosis of BIP. Clinical symptoms, pulmonary lesions, and pulmonary function tests were improved after oral glucocorticoid therapy.

Interstitial Lung Disease Associated with Polymyositis: Response to Cyclophosphamide and Prednisolone Combination Treatment (Cyclophosphamide와 Prednisolone 병합요법에 치료반응을 보인 다발성근염에 동반된 간질성폐질환 1예)

  • Moon, Jong-Ho;Park, Jun-Young;Lee, Sang-Moo;Kim, Hyeon-Tae;Uh, Soo-Taek;Chung, Yeon-Tae;Kim, Yong-Hoon;Park, Choon-Sik;Lee, Kyung-Soo;Kang, Dae-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.2
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    • pp.197-202
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    • 1993
  • Polymyositis (PM) is a inflammatory connective tissue disease involving predominantly skeletal muscles, characterized by symmetrical, proximal muscle weakness, inflammation, and frequently, degeneration. Interstitial lung disease in association with PM occurs in 5~10% of cases and carries an especially grave prognosis. Although the cause of lung involvement in PM is not known, the underlying pathologic process in the lung is an immune mediated inflammation of alveolar structures, alveolitis. It is of interest, therefore, that cyclophosphamide, an immune modulating agent, has been reported to be effective in the treatment of PM. We report a case of corticosteroid resistant PM associated with interstitial lung disease, successfully treated with cyclophosphamide. A 37-year-old female was presented with 8 months duration of cough, exertional dyspnea, and muscle weakness. She had typical symptoms, physical findings, and elevated muscle enzyme levels in serum with characteristic findings of muscle biopsy. She also had typical interstitial lung disease pattern on chest X-ray and high resolution CT with restrictive pattern on pulmonary function test. The findings of transbronchial lung biopsy was compatible with interstitial lung disease. She failed to respond to corticosteroid initially. Subsequently steroids and cyclophosphamide were given with excellent clinical improvement.

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A Case of Giant Cell Interstitial Pneumonia (거대세포 간절성 폐렴(Giant Cell Interstitial Pneumonia) 1예)

  • Kang, Kyeong-Woo;Park, Sang-Joon;Suh, Gee-Young;Han, Joung-Ho;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.;Choi, Jae-Wook
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.2
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    • pp.260-267
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    • 2000
  • Giant cell interstitial pneumonia. a synonym for hard metal pneumoconiosis, is a unique form of pulmonary fibrosis resulting from an exposure to hard metal dust. A case of biopsy-proved giant cell interstitial pneumonia in the absence of appropriate history of exposure to hard metal dust is reported. The patient presented with clinical features of chronic interstitial lung disease or idiopathic pulmonary fibrosis. He worked in a chemical laboratory at a fertilizer plant, where he had been exposed to various chemicals such as benzene and toluene. He denied having any other hobby in his house or job at work, which may have exposed him hard metal dust. High-resolution CT scan revealed multi-lobar distribution of ground glass opacity with peripheral and basal lung predominance. The retrieved fluid of bronchoalveolar lavage contained asbestos fiber and showed neutrotphil predominance. Surgical lung biopsy was performed for a definite diagnosis. Lung specimen showed alveolar infiltration of numerous multinucleated giant cells with mild interstitial fibrosis. Upon detailed examination of the lung tissue, one asbestos body was found. An analysis for mineral contents in lung tissue was performed. Compared with the control specimen, the amount of cobalt and several hard metal components in the lung tissue of this patient was ten times higher. We speculated that the inconsistency between occupational history and the findings of pathologic and mineralogical analyses could be explained by the difference in individual immunologic reactivity to hard metal dust despite the relatively small amount of unrecognized environmental exposure(ED: It's hard to understand what this phrase is trying to say).

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