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Terminal diffuse alveolar damage in relation to interstitial pneumonias. An autopsy study.
Am J Clin Pathol. 2003 May; 119(5):709-14.AJ

Abstract

Acute exacerbations of idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis (IPF/CFA) are rare and typically terminal events, but their relationship to underlying patterns of idiopathic interstitial pneumonias is unknown. We reviewed autopsy material from patients who died of diffuse alveolar damage in the clinical setting of pulmonary fibrosis, both idiopathic and with background fibrosing alveolitis with connective tissue disorders (FA-CTDs), and compared them with cases of acute interstitial pneumonia. Of 15 patients with acute exacerbations of IPF/CFA (n = 12) or FA-CTD (n = 3), 12 had a background pattern of usual interstitial pneumonia and 3 had fibrotic nonspecific interstitial pneumonia. All cases of fibrotic nonspecific interstitial pneumonia were seen in association with FA-CTD. The cause of acute exacerbations is unknown, but our data suggest that toxic effects of oxygen and triggering infection are unlikely causes. In patients with CTDs, it remains uncertain whether the acute exacerbation is related to the fibrosis, the associated CTD, or a combination of these factors. Acute exacerbations of IPF/CFA may be a more common terminal event than previously thought.

Authors+Show Affiliations

Department of Histopathology, Royal Brompton Hospital, London, England.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

12760290

Citation

Rice, Alexandra J., et al. "Terminal Diffuse Alveolar Damage in Relation to Interstitial Pneumonias. an Autopsy Study." American Journal of Clinical Pathology, vol. 119, no. 5, 2003, pp. 709-14.
Rice AJ, Wells AU, Bouros D, et al. Terminal diffuse alveolar damage in relation to interstitial pneumonias. An autopsy study. Am J Clin Pathol. 2003;119(5):709-14.
Rice, A. J., Wells, A. U., Bouros, D., du Bois, R. M., Hansell, D. M., Polychronopoulos, V., Vassilakis, D., Kerr, J. R., Evans, T. W., & Nicholson, A. G. (2003). Terminal diffuse alveolar damage in relation to interstitial pneumonias. An autopsy study. American Journal of Clinical Pathology, 119(5), 709-14.
Rice AJ, et al. Terminal Diffuse Alveolar Damage in Relation to Interstitial Pneumonias. an Autopsy Study. Am J Clin Pathol. 2003;119(5):709-14. PubMed PMID: 12760290.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Terminal diffuse alveolar damage in relation to interstitial pneumonias. An autopsy study. AU - Rice,Alexandra J, AU - Wells,Athol U, AU - Bouros,Demos, AU - du Bois,Roland M, AU - Hansell,David M, AU - Polychronopoulos,Vlasis, AU - Vassilakis,Dimitris, AU - Kerr,Jonathan R, AU - Evans,Timothy W, AU - Nicholson,Andrew G, PY - 2003/5/23/pubmed PY - 2003/6/5/medline PY - 2003/5/23/entrez SP - 709 EP - 14 JF - American journal of clinical pathology JO - Am. J. Clin. Pathol. VL - 119 IS - 5 N2 - Acute exacerbations of idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis (IPF/CFA) are rare and typically terminal events, but their relationship to underlying patterns of idiopathic interstitial pneumonias is unknown. We reviewed autopsy material from patients who died of diffuse alveolar damage in the clinical setting of pulmonary fibrosis, both idiopathic and with background fibrosing alveolitis with connective tissue disorders (FA-CTDs), and compared them with cases of acute interstitial pneumonia. Of 15 patients with acute exacerbations of IPF/CFA (n = 12) or FA-CTD (n = 3), 12 had a background pattern of usual interstitial pneumonia and 3 had fibrotic nonspecific interstitial pneumonia. All cases of fibrotic nonspecific interstitial pneumonia were seen in association with FA-CTD. The cause of acute exacerbations is unknown, but our data suggest that toxic effects of oxygen and triggering infection are unlikely causes. In patients with CTDs, it remains uncertain whether the acute exacerbation is related to the fibrosis, the associated CTD, or a combination of these factors. Acute exacerbations of IPF/CFA may be a more common terminal event than previously thought. SN - 0002-9173 UR - https://www.unboundmedicine.com/medline/citation/12760290/Terminal_diffuse_alveolar_damage_in_relation_to_interstitial_pneumonias__An_autopsy_study_ L2 - https://academic.oup.com/ajcp/article-lookup/doi/10.1309/UVAR-MDY8-FE9F-JDKU DB - PRIME DP - Unbound Medicine ER -