Diffuse Alveolar Damage: A Common Phenomenon in Progressive Interstitial Lung Disorders

Table 2

Idiopathic interstitial pneumonias that may behave acutely.

	IPF	AIP	NSIP
Age/sex	50–70 years, more common in males	All ages, as common in females than in males	40–60 years, also in children.; More common in females
Survival	Most of the patients had died after 2–4 years after of diagnosis	In-hospital mortality 12%–50%, 70% mortality in 6 months	5 year survival 74%–82 %
Course of disease	Usually slowly progressive over within years, sometimes rapidly, acute exacerbations may occur	Acute lower respiratory tract illness within 60 days	Stable or slowly progressing, acute exacerbations may occur
Treatment	No currently known efficient treatment.	Corticosteroids Immunosuppressants	Corticosteroids Immunosuppressants
Radiology	Honeycombing, reticulation, bronchiectasis and bronchiolectasis.; Ground glass opacities and consolidations in AE.	Diffuse ground glass opacities and infiltrates	Ground glass opacities.; No or scant honeycombing
Histopathology	Heterogenous appearance with areas of normal parenchyma, fibrosis and honeycomb cysts, which is termed as UIP. AE of UIP show also DAD in addition to UIP.	DAD with hyaline membranes, öedema and interstitial acute inflammation in acute phase. In organizing phase alveolar septal thickening with organizing fibrosis, type II pneumocyte hyperplasia, and patchy or diffuse airspace organization.	In cellular type of NSIP, chronic interstitial inflammatory cells involves alveolar walls, fibrotic form may include more advanced fibrosis.; The histology is usually uniform. In AE of NSIP also DAD is present.