HOME

TheInfoList



OR:

Lymphocytic interstitial pneumonia (LIP) is a syndrome secondary to
autoimmune In immunology, autoimmunity is the system of immune responses of an organism against its own healthy cells, tissues and other normal body constituents. Any disease resulting from this type of immune response is termed an " autoimmune disease" ...
and other
lymphoproliferative Lymphoproliferative disorders (LPDs) refer to a specific class of diagnoses, comprising a group of several conditions, in which lymphocytes are produced in excessive quantities. These disorders primarily present in patients who have a compromised i ...
disorders. Symptoms include fever, cough, and shortness of breath. Lymphocytic interstitial pneumonia applies to disorders associated with both monoclonal or polyclonal gammopathy.


Signs and symptoms

Patients with lymphocytic interstitial pneumonia may present with
lymphadenopathy Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency. Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. In cl ...
, enlarged
liver The liver is a major organ only found in vertebrates which performs many essential biological functions such as detoxification of the organism, and the synthesis of proteins and biochemicals necessary for digestion and growth. In humans, it ...
, enlarged spleen, enlarged
salivary gland The salivary glands in mammals are exocrine glands that produce saliva through a system of ducts. Humans have three paired major salivary glands ( parotid, submandibular, and sublingual), as well as hundreds of minor salivary glands. Salivary g ...
, thickening and widening of the extremities of the fingers and toes ( clubbing), and breathing symptoms such as shortness of breath and wheezing.


Causes

Possible causes of lymphocytic interstitial pneumonia include the
Epstein–Barr virus The Epstein–Barr virus (EBV), formally called ''Human gammaherpesvirus 4'', is one of the nine known human herpesvirus types in the herpes family, and is one of the most common viruses in humans. EBV is a double-stranded DNA virus. It is ...
, auto-immune, and HIV.


Diagnosis

Arterial blood gases may reveal signs of
hypoxemia Hypoxemia is an abnormally low level of oxygen in the blood. More specifically, it is oxygen deficiency in arterial blood. Hypoxemia has many causes, and often causes hypoxia as the blood is not supplying enough oxygen to the tissues of the body. ...
when tested in a lab.
Respiratory alkalosis Respiratory alkalosis is a medical condition in which increased respiration elevates the blood pH beyond the normal range (7.35–7.45) with a concurrent reduction in arterial levels of carbon dioxide. This condition is one of the four primary di ...
may also be present. Peripheral lymphocytosis can be observed. A lung biopsy may also be indicated.


Treatment

Patients presenting with no symptoms, and not affected by the syndrome may not require treatment. Corticosteroids have been reported to be of benefit in select patients. Bronchodilators may assist with breathing issues. Resolution may occur with the use of highly active anti-retroviral therapy used in patients with HIV, which suggests that the virus alone may cause immune cells to proliferate, or immunosuppression caused by HIV may lead to other viruses that induce the proliferation of immune cells, leading to LIP. There has been a decreased association of HIV and LIP since the introduction of antiretroviral therapy.Fagan, K. A., MD, & King Jr, T. E., MD. (2020, March 4). Lymphoid interstitial pneumonia in adults (1086842168 824689407 K. R. Flaherty MD, MS & 1086842169 824689407 H. Hollingsworth MD, Eds.). Retrieved November 29, 2020, from https://www.uptodate.com/contents/lymphoid-interstitial-pneumonia-in-adults However, responses to different treatments are widely varied, and no single first line treatment represents the default treatment for lymphocytic interstitial pneumonia.


References


External links

{{authority control Pneumonia