Interstitial pneumonia is a form of acute or chronic pulmonary process. A feature of the disease is its long and severe course, often with an unfavorable outcome and degeneration of lung tissue. More often develops in people after 40 years, significantly reducing not only the quality of life, but also disability, which leads patients to disability.

What is interstitial pneumonia?

Interstitial pneumonia is an evolving degenerative process of an inflammatory nature that affects the entire structure of the respiratory system with the subsequent transformation of lung tissue into pneumofibrosis or pneumosclerosis. Its appearance negatively affects the respiratory function of the lungs, provoking the development of failure.

Causes and Risk Factors

Interstitial pulmonary diseases (LLL) combine diseases with identical radiological changes in the respiratory organ in combination with bilateral lesion. A special place in this group is occupied by pneumonia of an idiopathic nature, however, its etiology remains unclear.

The cause of this type of pneumonia is:

  • infectious agents - mycoplasmas, rickettsia, pneumocysts, herpes virus, staphylococci, respiratory viruses, streptococci, legionella;
  • immunodeficiency phenomena in which antibodies are produced on a specific antigen.

In addition, there are a number of factors that contribute to a decrease in immunity and increase the risk of a serious pathological process.

These include:

  • the presence of foci of chronic inflammation (caries, tonsillitis, arthritis of the joints);
  • frequent respiratory viral infections;
  • HIV infection (applies to carriers);
  • prolonged use of certain medications;
  • smoking;
  • frequent alcohol intake;
  • heavy physical activity associated with professional activities or sports;
  • hormonal disbalance;
  • gestation and lactation;
  • inappropriate working conditions (work in hazardous work).

Any of these factors or their combination can give an impetus and provoke the beginning of the process.

Forms and stages of the disease

Interstitial lung diseases are a large group of pneumonia, consisting of various forms that differ in pathomorphological characteristics and certain symptoms.

According to the classification, the following forms of IL are distinguished:

  • pneumonia having an established etiological factor;
  • interstitial lung diseases of a granulomatous nature. Their development is provoked by various allergic pathologies (exogenous alveolitis);
  • ILD due to the presence of other diseases, such as oncology, chronic hepatitis.

A special place among the entire group is occupied by idiopathic pneumonia, which are presented in the following forms:

  • idiopathic pneumofibrosis (common pneumonia) - has a typical pattern of violation of the structural components of the lung tissue;
  • non-specific interstitial pneumonia - tissue inflammation occurs with uniform formation of fibrosis;
  • acute or Hamman-Rich syndrome - marked swelling of the alveolar walls with the presence of effusion in them and frequent formation of interstitial fibrosis is noted;
  • Desquamative - there is a slight uniform inflammatory process with a concentration of macrophages in the alveoli;
  • lymphoid - in the presence of severe lymphocyte infiltration;
  • cryptogenic organizer - proceeds with the formation of exudative secretions and polypous granulations in bronchioles;
  • respiratory bronchiolitis - minimal signs of inflammation and fibrosis are formed.

Any form of pneumonia can occur in the form of a focal or diffuse process, sometimes covering only a fraction or the entire area of ​​the lung.

Inflammation in the lung tissue during the progression of the disease goes through several stages of its development:

  • Stage 1 - the phase of compaction of the alveolar tissue lasting 24 hours, during which the production of effusion in the lesion is noted;
  • Stage 2 - phase of compaction of the lung tissue with the appearance of hyperemia in the lesion;
  • Stage 3 - the phase of fibrin accumulation in the lesion with the appearance of a gray-brown tint in it, which indicates the beginning of the process of lung destruction, since there is a massive replacement of normal tissue with fibrosis;
  • Stage 4 - the resolution phase, in which the exudate begins to dissolve, and the alveoli partially recover, but the fibrous tissue predominates, making the lung look like a honeycomb. This process can be a long one.

Symptoms and the further course of interstitial pneumonia will depend not only on the form of the disease, but also on the stage of development.

In medical practice, the bulk of patients have idiopathic pulmonary fibrosis, which is observed more in smoking patients.

Symptoms of Interstitial Pneumonia

The clinic, despite the variety of forms of ILI, have common signs in the development of pathology.

As a rule, the disease begins gradually, and the following symptoms come to the fore:

  • fever to subfebrile numbers;
  • weakness;
  • fast fatiguability;
  • weight loss.

An objective examination listens for hard breathing. At the initial stage of the disease, wheezing is absent, but shortness of breath is the main symptom. It appears at the initial stages of the development of the disease during physical exertion. But over time, it aggravates and disturbs during rest, while patients experience difficulty in inhaling. Often such shortness of breath is accompanied by wheezing. As the process worsens, a cough appears without sputum or with a slight separation of the secretion of a mucous character.

With the progression of inflammation, respiratory failure increases, additionally manifested by cyanosis, deformation of the fingers and nail plates. In the future, there is a decrease in cardiopulmonary function, which can lead to a violation of the shape of the chest.

The severity of the clinical manifestations of the disease will depend not only on the individual characteristics of the patient, but also on the presence of concomitant chronic pathologies, age, and the state of the body's defenses.

Important! An increase in temperature, the appearance of shortness of breath, headache and malaise require the obligatory consultation of a doctor to exclude the development of interstitial pneumonia.

Features of the disease in children

Interstitial pulmonary pathology can develop not only in adults, but also in children who tolerate the disease much harder.

In babies, it has its own characteristics, which is manifested in the following form:

  • the initial sign of pneumonia is shortness of breath, there are no catarrhal phenomena;
  • symptoms of intoxication with a high temperature quickly increase, up to 39-40 degrees, which can last up to 1.5 weeks, while antipyretics can be ineffective;
  • against the background of intoxication, a drop in blood pressure, the appearance of arrhythmia with a subsequent tendency to the development of heart failure can be noted;
  • shortness of breath and cyanosis of the nasolabial triangle have a tendency to progression;
  • a serious condition is accompanied by a slight cough with the release of scanty sputum.

Pneumonia in children against the background of an immature immune system can cause complications in the form of emphysema and pulmonary edema. Therefore, the treatment of pneumonia in babies is carried out in a hospital setting.

Diagnostics

The diagnosis of interstitial pneumonia is difficult. A decisive role in the diagnosis of pulmonary pathology is played by a thorough collection of medical history, objective data (auscultation and percussion of the lungs, determination of the severity and type of shortness of breath, identification of the nature of the heartbeat).

Additionally, the following examinations are prescribed:

  • blood, urine for a general analysis;
  • X-ray of the lungs in 2 projections;
  • ECG;
  • CT of the lungs;
  • bronchoscopy (if necessary);
  • spirometry;
  • blood to determine the gas composition;
  • biopsy of lung tissue indicated.

After the diagnosis is established, the specialist determines the further tactics of therapeutic measures to relieve symptoms and transfer the disease to the stage of regression.

Treatment of pneumonia

The diagnosis of the early development of pneumonia plays a large role in achieving a positive result in the treatment of pulmonary pathology. Therapy of pneumonia is based on the relief of the inflammatory process.

The following types of medications are used:

  • cytostatic agents;
  • hormonal medications;
  • antibacterial drugs;
  • antifibrotic agents;
  • antioxidants;
  • vitamins;
  • cardiac glycosides.

Oxygen therapy is actively used. Drug treatment is carried out for a long time, from 3 months to several years with mandatory monitoring of effectiveness after a certain time.

Possible complications and consequences

Since interstitial pneumonia is a serious pulmonary pathology, it can cause a number of complications.

These include:

  • pneumofibrosis;
  • pulmonary failure;
  • heart failure;
  • secondary infection of the lung;
  • the formation of a "cellular" lung;
  • malignancy into a malignant formation;
  • a sharp decrease in body weight, underweight.

Timely diagnosis and comprehensive treatment of pneumonia with the implementation of all the doctor's recommendations will maximize the patient's condition and avoid serious complications of pulmonary pathology.

Prognosis for interstitial lung diseases

The prognosis for this lung disease will largely depend on the form of the process and the prevalence of fibrosis. On average, after the onset of the pathological process, the patient lives another 5-6 years. The most unfavorable prognosis is acute interstitial pneumonia, in which the lethal outcome can reach 70%.

Quality therapy leads to regression of the disease and stabilization of the process in 75% of cases. About 40% of patients live with this disease for up to 10 years. The best prognosis for lymphoid and cryptogenic organizing interstitial pneumonia.

Preventative measures

To prevent the development of interstitial pneumonia, it is necessary to carry out a number of preventive measures, which include the following provisions:

  • exclude smoking;
  • vaccinate every year before seasonal epidemics of influenza and colds;
  • increase immunity by taking vitamin complexes and practicing tempering procedures;
  • regularly engage in physical education with the inclusion of respiratory gymnastics in the complex of exercises;
  • observe personal hygiene;
  • timely treatment of chronic diseases;
  • to be at the annual medical examination at the clinic;
  • do sport;
  • Avoid public places during seasonal epidemics.

By following these simple rules of prevention, you can prevent the onset of a serious illness such as interstitial pneumonia.

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