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Difference between revisions of "Diffuse alveolar damage"
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{{ Infobox diagnosis | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | | Name = {{PAGENAME}} | ||
| Image = Hyaline membranes - very high mag.jpg | | Image = Hyaline membranes - very high mag.jpg | ||
| Width = | | Width = | ||
| Caption = Hyaline membranes. [[H&E stain]]. | | Caption = Hyaline membranes. [[H&E stain]]. | ||
| Line 27: | Line 27: | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = often poor, dependent on severity and comorbidities | | Prognosis = often poor, dependent on severity and comorbidities | ||
| Other = | | Other = histologic correlate of: acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), transfusion related acute lung injury (TRALI); may be seen in chronic [[interstitial lung disease]] - esp. [[IPF]] | ||
| ClinDDx = | |||
| Tx = dependent on underlying cause | | Tx = dependent on underlying cause | ||
}} | }} | ||
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*Abrupt hypoxemia with pulmonary infiltrates leading to epithelial cell and endothelial cell death not accompanied by cardiac failure.<ref name=Ref_PCPBoD8_364>{{Ref PCPBoD8|364}}</ref> | *Abrupt hypoxemia with pulmonary infiltrates leading to epithelial cell and endothelial cell death not accompanied by cardiac failure.<ref name=Ref_PCPBoD8_364>{{Ref PCPBoD8|364}}</ref> | ||
DAD is the histologic correlate of: | Classically, DAD is the histologic correlate of: | ||
*Acute respiratory distress syndrome (ARDS). | *Acute respiratory distress syndrome (ARDS). | ||
**[[AKA]] adult respiratory distress syndrome (ARDS) to differentiate it from ''[[respiratory distress syndrome]]'' in infants. | **[[AKA]] ''adult respiratory distress syndrome'' (ARDS) to differentiate it from ''[[respiratory distress syndrome]]'' in infants. | ||
*Acute interstitial pneumonia (AIP). | *Acute interstitial pneumonia (AIP). | ||
The DDx is broad:<ref>{{Ref WMSP|91}}</ref> | The DDx is broad:<ref>{{Ref WMSP|91}}</ref> | ||
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*Inflammatory. | *Inflammatory. | ||
*Idiopathic. | *Idiopathic. | ||
Notes: | |||
*DAD may ''not'' be present in all cases that are clinically ''ARDS''.<ref name=pmid23370917>{{cite journal |authors=Thille AW, Esteban A, Fernández-Segoviano P, Rodriguez JM, Aramburu JA, Peñuelas O, Cortés-Puch I, Cardinal-Fernández P, Lorente JA, Frutos-Vivar F |title=Comparison of the Berlin definition for acute respiratory distress syndrome with autopsy |journal=Am J Respir Crit Care Med |volume=187 |issue=7 |pages=761–7 |date=April 2013 |pmid=23370917 |doi=10.1164/rccm.201211-1981OC |url=}}</ref> | |||
*Transfusion related acute lung injury (TRALI) may have DAD; however, cases are reported without the pattern.<ref name=pmid18673344>{{cite journal |authors=Danielson C, Benjamin RJ, Mangano MM, Mills CJ, Waxman DA |title=Pulmonary pathology of rapidly fatal transfusion-related acute lung injury reveals minimal evidence of diffuse alveolar damage or alveolar granulocyte infiltration |journal=Transfusion |volume=48 |issue=11 |pages=2401–8 |date=November 2008 |pmid=18673344 |doi=10.1111/j.1537-2995.2008.01879.x |url=}}</ref> | |||
*DAD may be seen in acute exacerbations of chronic [[interstitial lung disease]], e.g. idiopathic pulmonary fibrosis.<ref name=pmid21637367>{{cite journal |authors=Kaarteenaho R, Kinnula VL |title=Diffuse alveolar damage: a common phenomenon in progressive interstitial lung disorders |journal=Pulm Med |volume=2011 |issue= |pages=531302 |date=2011 |pmid=21637367 |pmc=3099744 |doi=10.1155/2011/531302 |url=}}</ref> | |||
==Microscopic== | ==Microscopic== | ||