diffuse alveolar damage


Also found in: Dictionary, Thesaurus, Acronyms, Encyclopedia.

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 ?
Acute fibrinous and organizing pneumonia: a histological pattern of lung injury and possible variant of diffuse alveolar damage. Arch Pathol Lab Med.
Idiopathic inflammatory myopathy with diffuse alveolar damage. Clin Rheumatol.
Nonhomogeneous Immunostaining of hyaline membranes in different manifestations of diffuse alveolar damage. Clinics (Sao Paulo).
(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.
Histopathologic analysis (online Technical Appendix) identified pulmonary consolidation indicative of diffuse alveolar damage. Alveolar and bronchiolar lumina showed edema and contained variable numbers of macrophages, neutrophils, and erythrocytes mixed with fibrin and cellular debris.
The 2 strains elicited dramatically different disease courses and histopathologic signatures, although both strains caused death in 100% of those infected, evoked the expected diffuse alveolar damage, and led to comparable virus titers in the lungs.
(14) There may be a variable degree of organizing pneumonia and the presence of hyaline membranes of diffuse alveolar damage. The pathologic approach to patients with DAH has been nicely reviewed.
Common findings in both patients were diffuse alveolar damage and positive staining for influenza A virus antigen in alveolar epithelial cells (Figure 1).
They were asked to classify the histopathologic pattern according to the 2002 ATS/ERS statement on IIP (1) as follows: UIP, nonspecific interstitial pneumonia, organizing pneumonia, diffuse alveolar damage, respiratory bronchiolitis, desquamative interstitial pneumonia, and other specific diseases.
The autopsy showed proliferative phase of diffuse alveolar damage, interstitial pneumonia, focal hemorrhage, and bronchiolitis.
(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.
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. Distinctive airspaces or small airway lesions resembling bronchiolitis obliterans organizing pneumonia were also detected.