Pneumonitis

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Classification according to ICD-10
J68.- Respiratory diseases caused by inhalation of chemical substances, gases, smoke and fumes
J69.- Pneumonia due to solid and liquid substances
J70.- Respiratory diseases caused by other exogenous substances
J84.- Other interstitial lung diseases
ICD-10 online (WHO version 2019)

The term pneumonitis stands for an inflammatory change in the lungs . In contrast to pneumonia , however, the triggers are not microorganisms such as bacteria or fungi , but usually influences that have a pneumotoxic effect such as high-energy radiation or drugs , i.e. noxious substances of a physical and chemical nature.

causes

The cause can be, for example, numerous drugs, especially those that are used as part of chemotherapy . In addition, clinical observations suggest that fluoroquinolone antibiotics can trigger pneumonitis with acute respiratory failure and persistent interstitial infiltrates. The radiation therapy can cause pneumonitis, especially in the irradiated regions. Other causes can be plant toxins or inhalation of substances with a pneumotoxic effect (e.g. fluorocarbon compounds, cobalt or tungsten ). In addition, diseases such as uremia can in rare cases lead to pneumonitis.

Alveolar and interstitial lung damage can also be caused by irritating and toxic aerosols that are used as ingredients or additives in e-cigarettes or other "vaping" devices (evaporators). As a result of the illegal use of vitamin E acetate as an extender to vaporize tetrahydrocannabinol , an epidemic of acute toxic lung damage with interstitial pneumonitis, known as "e-cigarette, or vaping, product use associated lung," arose in the USA from August 2019 injury " ( EVALI ).

Clinical appearance

Pneumonitis shows unspecific lung symptoms such as mostly dry cough, shortness of breath and in some cases a slight increase in body temperature. The diagnosis is made on the basis of the medical history and clinical symptoms, supplemented by a lung function test , an X-ray of the lungs , and, if necessary, computed tomography and bronchoscopy with bronchoalveolar lavage. Histologically, the picture of an interstitial pneumonia is typically found .

therapy

Therapy should, if possible, consist in eliminating the effects of the causes. The administration of corticosteroids can also be indicated symptomatically.

Individual evidence

  1. ↑ a b D. Ukena: Drug-Induced Lung Diseases. In: The pulmonologist. May 2007, pp. 201-212, doi : 10.1007 / s10405-007-0149-9 .
  2. ↑ D. Steiger, L. Bubendorf, M. Oberholzer, M. Tamm, JD Leuppi: Ciprofloxacin-induced acute interstitial pneumonitis . In: European Respiratory Journal . tape 23 , no. 1 , January 1, 2004, ISSN  0903-1936 , p. 172–174 , doi : 10.1183 / 09031936.03.00057903 , PMID 14738249 ( ersjournals.com [accessed April 18, 2018]).
  3. ↑ D. Jammalamadaka, H. Zhang, S. Sandur: Pulmonary Toxicity with Fluoroquinolones . In: The Internet Journal of Pulmonary Medicine . tape 11 , no. 2 , December 31, 2008 ( ispub.com [accessed April 18, 2018]).
  4. ^ H. Rübben: uro-oncology. Springer, 2000, ISBN 3-540-67310-5 , pp. 698ff. (on-line)
  5. ↑ Gernot Katzer: Perilla (Perilla frutescens [L.] Britton). (online) ; last accessed on December 3, 2012.
  6. ↑ M. Guirgius et al .: Tox-Zentrum: Brennpunkte 2002 . In: Swiss Medical Journal . 2003, 84 (45), pp. 2353-2356.
  7. ↑ M. Goldoni et al .: Exhaled Breath Condensate as a Suitable Matrix to Assess Lung Dose and Effects in Workers Exposed to Cobalt and Tungsten. In: Environ Health Perspect . 112 (13), 2004 September, pp. 1293-1298. PMC 1247519 (free full text)
  8. ↑ GH Schlund: Postoperative uremic epicarditis and pneumonitis after mistaken nephrectomy for angiomyolipoma. In: The Urologist. 38/4/1998, pp. 370-373. doi : 10.1007 / s001310050219 .
  9. ↑ Hendrik Suhling, Tobias Welte, Thomas Fuehner: Case reports from three patients with acute lung damage after using e-cigarettes . Deutsches Ärzteblatt Int 2020, Volume 117, Pages 177 - 182, DOI: 10.3238 / arztebl.2020.0177
  10. ↑ Jennifer E. Layden, Isaac Ghinai, Ian Pray, Anne Kimball, Mark Layer, Mark W. Tenforde, Livia Navon, Brooke Hoots, Phillip P. Salvatore, Megan Elderbrook, Thomas Haupt, Jeffrey Kanne, Megan T. Patel, Lori Saathoff -Huber, Brian A. King, Ph.D., Josh G. Schier, Christina A. Mikosz, Jonathan Meiman et al .: Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Final Report . New England Journal of Medicine 2020, Volume 382, ​​Issue 10 March 5, 2020, Pages 903-916 , DOI: 10.1056 / NEJMoa1911614
  11. ^ KJ Bühling et al.: Intensive course: General and special pathology. Urban & Fischer-Verlag, 2004, ISBN 3-437-42411-4 , p. 210, (online)