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 ?
Terminal diffuse alveolar damage in relation to interstitial pneumonias: an autopsy study.
Organizing diffuse alveolar damage associated with progressive systemic sclerosis.
Idiopathic inflammatory myopathy with diffuse alveolar damage.
In contrast, those influenza viruses which are highly pathogenic toward humans, from the pandemic viruses of 1918 (H1N1), 1957 (H2N2), and 1968 (H3N2) to the subtype H5N1 strains isolated from humans since 2003, additionally colonize the bronchiolar and alveolar epithelia, preferentially or not, and cause diffuse alveolar damage as an additional primary lesion (20-23).
Although both viruses share the same pathogenicity, replication kinetics, and concentration peak, and although they both evoke diffuse alveolar damage by the endpoint day, they differ dramatically in terms of the ARDS course and pathologic signature.
Potential Etiologies of Organizing Pneumonia With Intraluminal Polyps (a) Diffuse alveolar damage, organizing Aspiration pneumonia, organizing Resolving infections Postobstruction organization Hypersensitivity pneumonitis Organization after exposure to fumes and toxins Collagen vascular disease Acute lung transplant rejection Drug reactions Secondary to bone marrow transplantation or other organ transplantation Reaction to radiation therapy or chemotherapy Chronic eosinophilic pneumonia Secondary reaction with chronic bronchiolitis Reparative process adjacent to abscess, necrotic tumor, infarct, etc Secondary to a hematologic disorder Inflammatory bowel disease-related small airways disease Wegener granulomatosis Idiopathic (a) Data were derived from Cagle et al.
Diffuse alveolar damage in which no known causative etiology can be elucidated is clinically termed acute interstitial pneumonia, which also corresponds to cases historically referred to as Hamman-Rich syndrome.
Regional alveolar damage (RAD): a localized counterpart of diffuse alveolar damage.
Sex Diagnosis Cause of Death 1 28/F SLE Alveolar hemorrhage 2 22/F SLE Alveolar hemorrhage 3 34/F SLE Mesenteric artery thrombosis, small intestinal infarction, septicemia 4 19/M Overlap Colonic perforation, syndrome, peritonitis, septicemia SLE-scleroderma 5 49/M SLE Diffuse alveolar damage, aspergillosis 6 21/M SLE Herpes simplex pneumonia Patient No.
Patient 5 had pulmonary pathology consisting of diffuse alveolar damage and invasive pulmonary aspergillosis.
Diffuse alveolar damage and acute interstitial pneumonitis: histochemical evaluation with lectins and monoclonal antibodies against surfactant apoprotein and collagen type IV.
It is possible that HPS may manifest a very early phase of severe diffuse alveolar damage and in the few cases when patients survived in the hospital for 2 days or more, the histologic changes may more closely resemble those of AIP.