scholarly journals Successful combination therapy with corticosteroids, biweekly intravenous pulse cyclophosphamide and cyclosporin A for acute interstitial pneumonia in patients with dermatomyositis : report of three cases

2013 ◽  
Vol 36 (2) ◽  
pp. 122-128 ◽  
Author(s):  
Akitake SUZUKI ◽  
Norikazu SHOJI ◽  
Eigo KIKUCHI ◽  
Kazuaki UEKUBO ◽  
Naoko AOKI ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Cyclosporin A ◽  
Interstitial Pneumonia ◽  
Pulse Cyclophosphamide ◽  
Acute Interstitial Pneumonia ◽  
Intravenous Pulse Cyclophosphamide

scholarly journals Coadministration of Cyclosporin a with Prednisolone in Acute Interstitial Pneumonia Complicating Polymyositis/Dermatomyositis

2012 ◽  
Vol 5 ◽  
pp. CMAMD.S9398 ◽  
Author(s):  
Yasuhiro Shimojima ◽  
Wataru Ishii ◽  
Masayuki Matsuda ◽  
Nagaaki Katoh ◽  
Ko-ichi Tazawa ◽  
...  
Keyword(s):  
Cyclosporin A ◽  
Interstitial Pneumonia ◽  
Intravenous Administration ◽  
Therapeutic Option ◽  
Clinical Effectiveness ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Acute Interstitial Pneumonia ◽  
Therapeutic Outcomes ◽  
Death Group

Objective To investigate clinical effectiveness of prednisolone (PSL) and cyclosporin A (CyA), particularly continuous intravenous administration of the latter, in patients with interstitial pneumonia (IP) associated with polymyositis/dermatomyositis (PM/DM). Methods We reviewed the clinical findings and therapeutic outcomes of patients with PM/DM who had received PSL and CyA (PSL + CyA, n = 21 for DM and 2 for PM) or the former alone (n = 12 for DM and 7 for PM). All patients receiving PSL + CyA had active IP. Results Fifteen of the 21 DM patients receiving PSL + CyA showed favorable therapeutic outcomes of IP (recovery group), while the remaining 6 died of respiratory failure (death group). Before treatment PaO2 in room air and %VC were significantly lower, and the total CT score was significantly higher in the death group than in the recovery one. Continuous intravenous administration of CyA was performed in 6 patients for severe IP requiring oxygen therapy, and of these 2 showed complete recovery from it. Conclusions Coadministration of PSL and CyA, particularly continuous intravenous infusion of the latter, from the early phase of illness may be a potent therapeutic option for PM/DM patients with decreases in PaO2 and %VC and/or a high total CT score suggestive of a poor prognosis.

A Rare Case of Acute Interstitial Pneumonia Diagnosed at Autopsy

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S153-S154
Author(s):  
E Conner ◽  
D Troxclair ◽  
H Khokhar ◽  
W Beversdorf
Keyword(s):  
Respiratory Failure ◽  
Interstitial Pneumonia ◽  
Diffuse Alveolar Damage ◽  
Ventilatory Support ◽  
Respiratory Illness ◽  
High Dose ◽  
Atypical Pneumonia ◽  
Acute Interstitial Pneumonia ◽  
Diagnostic Role ◽  
History Of

Abstract Introduction/Objective Acute interstitial pneumonia (AIP) is a rare disease clinically characterized by rapidly progressing respiratory failure in individuals with no history of respiratory illness or other inciting factors. While most often diagnosed in middle-aged adults, it may present in any age group. Initial presentation is described as influenza- like, and respiratory failure requiring ventilatory support often progresses within weeks to months. Prognosis is poor, with an estimated mortality rate approaching 80% without treatment. Methods We present the case of a 44-year-old male nonsmoker with no significant medical history, who presented in 2018 with 1.5 months of dyspnea and headache initially diagnosed as atypical pneumonia. Chest imaging revealed bilateral opacities; however, microbial workup revealed no evidence of infectious etiology. Autoimmune serology studies were likewise unrevealing. Despite aggressive supportive and medical management, he deteriorated to respiratory failure and succumbed. Results At autopsy, the lungs were symmetrically congested and edematous (combined weight 2,340 g) but free of evident consolidation or discrete lesions. Microscopic examination revealed diffuse alveolar damage with extensive hyaline membrane formation, interstitial edema, and fibroblastic proliferation. The vasculature was severely congested, and the alveoli contained hemorrhage and scattered macrophages. No fungal or mycobacterial elements were identified by staining. Based on the histologic features and clinical context, the diagnosis of AIP was made. Conclusion AIP is a rare, aggressive, and diagnostically challenging disease that includes a broad range of both clinical and histologic differentials. Timely recognition and intervention with aggressive respiratory support and high- dose glucocorticoids are the mainstays of clinical management. The diagnostic role of histology is significant, but hinges on early clinical consideration of AIP as disease progression may later preclude the biopsy procedure. We share this case to raise awareness of this rapidly progressive and diagnostically troubling interstitial lung disease while emphasizing the importance of clinicopathologic correlation.

Acute Interstitial Pneumonia

1986 ◽  
Vol 10 (4) ◽  
pp. 256-267 ◽  
Author(s):  
Anna-Luise A. Katzenstein ◽  
Jeffrey L. Myers ◽  
Michael T. Mazur
Keyword(s):  
Interstitial Pneumonia ◽  
Acute Interstitial Pneumonia
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