diffuse alveolar damage


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a·dult res·pi·ra·to·ry dis·tress syn·drome (ARDS),

acute lung injury from a variety of causes, characterized by interstitial or alveolar edema and hemorrhage as well as perivascular pulmonary edema associated with hyaline membrane formation, proliferation of collagen fibers, and swollen epithelium with increased pinocytosis.

diffuse alveolar damage

A term of art referring to the histologic findings in adult respiratory distress syndrome (ARDS), which is characterised by an acute onset of diffuse pulmonary infiltrates.

Aetiology
AIDS, air embolism, fat embolism, aspiration of gastric content, cardiopulmonary bypass, connective tissue disease (lupus, rheumatoid arthritis, scleroderma, dermatomyositis), DIC, drugs (either therapeutic—e.g., bleomycin, busulfan, cytoxan, methotrexate, nitrofurantoin—or drugs of abuse), heat injury, haemosiderosis, high altitude, iatrogenic (PEEP), infection (viruses, e.g., herpes, CMV; protozoans, e.g., Toxoplasma gondii, Pneumocystis jiroveci), molar pregnancy, noxious fumes (e.g., beryllium, cadmium, mercury, zinc), toxins (e.g., ammonia, kerosene, paraquat, phosgene), gases (e.g., CO2, NO2), (acute) pancreatitis, radiation, sepsis and endotoxins, shock, uraemia.
 
DiffDx
Goodpasture’s syndrome, hypersensitivity pneumonitis, multisystem organ failure, pneumonia (aspiration, bacterial, eosinophilic, nosocomial, Pneumocystis jiroveci, ventilator-related), respiratory failure, sepsis, shock (haemorrhagic, septic, toxic), perioperative lung management, toxicity (heroin, paraquat, salicylates), transfusion reaction, tumor lysis, ventilation.

diffuse alveolar damage

DAD The histologic findings in ARDS, which is characterized by an acute onset of diffuse pulmonary infiltrates Etiology AIDS, air embolism, cardiopulmonary bypass, connective tissue disease–SLE, rheumatoid arthritis, scleroderma, dermatomyositis, drugs–therapeutic–eg, bleomycin, busulfan, cytoxan, MTX, nitrofurantoin or drugs of abuse, eosinophilic granuloma, heat injury, hemosiderosis, high altitude, iatrogenic–PEEP, infections–viruses–eg, herpes, CMV; protozoans–eg, toxoplasma, pneumocystis, molar pregnancy, noxious fumes–eg beryllium, cadmium, mercury, zinc, toxins–eg ammonia, kerosene, paraquat, phosgene, or gases–eg CO2, NO2, acute pancreatitis, shock, uremia. See Adult respiratory distress syndrome.
References in periodicals archive ?
Histopathologic examination of lung specimens from SARS victims revealed features of diffuse alveolar damage with marked pulmonary edema and hyaline membrane formation.
36,37) Diffuse alveolar damage may contain organizing fibroblastic tissue within alveolar ducts in particular, but this is not the dominant finding, and OP lacks the hyaline membranes or acute DAD and does not show the prominent interstitial myxoid fibrosis or prominent type 2 pneumocyte hyperplasia of the organizing phase of DAD.
Some pathologists used diagnoses of organizing pneumonia, desquamative interstitial pneumonia, respiratory bronchiolitis, or diffuse alveolar damage.
Histopathologic analysis (online Technical Appendix) identified pulmonary consolidation indicative of diffuse alveolar damage.
8) In fact, areas of diffuse alveolar damage in patients with restrictive allograft syndrome after lung transplantation with ensuing PPFE appear to support this hypothesis.
This array of morphologic alterations is known as diffuse alveolar damage.
The term acute interstitial pneumonia, also termed Hamman-Rich syndrome, describes cases of diffuse alveolar damage (DAD) that are idiopathic.
Common findings in both patients were diffuse alveolar damage and positive staining for influenza A virus antigen in alveolar epithelial cells (Figure 1).
19,20) Histologic changes of AMR described by various authors include septal capillary necrosis, capillaritis, and diffuse alveolar damage (DAD).
The autopsy showed proliferative phase of diffuse alveolar damage, interstitial pneumonia, focal hemorrhage, and bronchiolitis.
Proliferative-phase diffuse alveolar damage is characterized by fibroblast and type 2 pneumocyte proliferation, with associated squamous metaplasia and thromboemboli; and late or resolving phase shows remodeled lung architecture with dense fibrosis, ultimately culminating in honeycomb lung change.
In SARS patients, coronavirus particles were seen by electron microscopy in lung cells of most cases, and the lung injuries consistently exhibited features of diffuse alveolar damage.