Fatal desquamative interstitial pneumonia associated with proven CMV infection in an 8-month-old boy

Schroten, Horst; Manz, Shannon; Köhler, H.; Wolf, U.; Brockmann, Michael; Riedel, Frank

doi:10.1002/(sici)1099-0496(199805)25:5<345::aid-ppul10>3.0.co;2-4

Cited by 12 publications

(3 citation statements)

References 11 publications

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“…Thus, it is of significance that a number of exposures are reported to have an association with DIP include marijuana smoking, beryllium, diesel fume, fire extinguisher powder, copper, asbestos, and certain chemicals used in textile processing [7], [8], [9]. In addition, DIP has been reported as a complication of autoimmune diseases such as rheumatoid arthritis and scleroderma [8], [10] and has also occurred in association with infections including cytomegalovirus, hepatitis C, and aspergillus [11], [12]. Genetic factors do not seem to have a dominant role.…”

Section: Discussionmentioning

confidence: 99%

Desquamative interstitial pneumonia with clinical, radiological and histologic correlation

Medenica

Medenica²

2019

Radiology Case Reports

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Respiratory bronchiolitis-associated interstitial lung disease (ILD), desquamative interstitial pneumonia (DIP), and pulmonary Langerhans cell histiocytosis are entities of smoking-related ILD. While clinically regarded as 2 separate forms of idiopathic interstitial pneumonia, DIP, and respiratory bronchiolitis-associated ILD are thought to be representing ends of a continuous spectrum of disease that primarily affects tobacco smokers. This case report presents a 53-year-old female patient who has 58 pack-year smoking history who has been experiencing a dry cough and epigastric pains for 2 years. Open-lung biopsy is performed and histopathology indicated smoking-related interstitial fibrosis. The patient did not stop smoking, which after a year leads to significant clinical deterioration with a notable decrease in diffusion for carbon monoxide capacity. Upon smoking cessation and treatment with corticosteroids, a significant clinical improvement is achieved. In smokers complaining of cough and reduced exercise tolerance and in whom evidence of interstitial fibrosis is demonstrated radiologically, DIP should be considered as a differential diagnosis. Smoking is the exclusive etiologic factor of pathogenesis of DIP.

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Section: Discussionmentioning

confidence: 99%

Desquamative interstitial pneumonia with clinical, radiological and histologic correlation

Medenica

Medenica²

2019

Radiology Case Reports

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“…In addition, DIP has been associated with connective tissue disease [43,44], rheumatoid arthritis [45], drugs such as sirolimus [46], infection [47][48][49], and users of large amounts of marijuana [50]. All known causes of DIP other than tobacco smoking are summarised in table 2.…”

Section: ¡063610mentioning

confidence: 99%

Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology

Godbert¹,

Wissler²,

Vignaud³

2013

Eur Respir Rev

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Desquamative interstitial pneumonia (DIP) is characterised by the accumulation of numerous pigmented macrophages within most of the distal airspace of the lung and, sometimes, the presence of giant cells. Diagnosis of DIP is not easy and requires surgical lung biopsy. DIP is usually associated with tobacco smoke. However, the association between smoking and DIP is less robust than that with respiratory bronchiolitis with interstitial lung disease or pulmonary Langerhans' cell histiocytosis; approximately 10-42% of patients with DIP are nonsmokers. DIP can also occur in patients following exposure to certain inhaled toxins (occupational exposure) and drugs, and may occur in the context of certain viral illnesses and autoimmune diseases. In the context of DIP, occupational exposure should be systematically investigated.

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“…Human cytomegalovirus (CMV) is a member of the Herpesviridae family of DNA viruses and is responsible for a wide range of diseases in neonates and immunocompromised patients 1 . Although 15~25% of perinatally infected preterm infants may develop clinical illnesses such as pneumonia, hepatitis or sepsis-like illness, bradycardia, hepatosplenomegaly, distended bowel, anemia, or thrombocytopenia 1,2 , it is usually associated only rarely with clinical illness in term infants and usually follows a benign course in immunocompetent infants 3,4 . Bronchiolitis obliterans (BO) is a rare, fibrosing form of chronic obstructive lung disease that follows severe insults to the lower respiratory tract and results in narrowing and/or complete obliteration of the small airways 5 .…”

mentioning

confidence: 99%

Bronchiolitis obliterans caused by CMV in a previously healthy Asian infant

Byun,

Kim,

Lee

et al. 2014

Turk J Pediatr

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Cytomegalovirus (CMV) is currently the most common cause of congenital infection and the leading infectious cause of brain damage and hearing loss in children. Perinatal CMV infection rarely causes clinical manifestations in normal individuals and usually follows a benign course in immunocompetent infants. However, ~15-25% of infected preterm infants may develop pneumonia, hepatitis or sepsis-like illness, bradycardia, hepatosplenomegaly, distended bowel, anemia, or thrombocytopenia. Bronchiolitis obliterans (BO) is a rare, fibrosing form of chronic obstructive lung disease that follows severe insults to the lower respiratory tract and results in narrowing and/or complete obliteration of the small airways. In non-transplant children, the most common form of BO is a severe lower respiratory tract infection, especially of adenovirus. We experienced a case of a 37-day-old male who was diagnosed as BO on chest computed tomography (CT) after CMV pneumonia. To our best knowledge, this is the first case of BO caused by CMV pneumonia in a healthy infant.

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Fatal desquamative interstitial pneumonia associated with proven CMV infection in an 8-month-old boy

Cited by 12 publications

References 11 publications

Desquamative interstitial pneumonia with clinical, radiological and histologic correlation

Desquamative interstitial pneumonia with clinical, radiological and histologic correlation

Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology

Bronchiolitis obliterans caused by CMV in a previously healthy Asian infant

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