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Nonspecific interstitial pneumonia (NSIP), along with IPF, is one of the most common forms of IIP. NIP can be idiopathic; this form is included in the IIP group. However, a morphological picture corresponding to the NIP pattern also occurs in cases of lung damage in patients with CTD, hypersensitivity pneumonitis, radiation pneumonitis, etc.
The prognosis of patients with NIP is more favorable than with IPF. The clinical course and survival of glucophage pills on the severity of pulmonary fibrosis. The ten-year survival rate for NIP is about 35%. Spontaneous cases of recovery without treatment in NIP are unknown; GCS therapy without or with the addition of cytostatics leads to improvement or stabilization in approximately 75% of patients.
Cryptogenic organizing pneumonia.
The disease most often develops in people aged 50-60 years; men and women get sick equally often. COP is characterized by an acute or subacute course, the clinical picture often resembles bacterial pneumonia. The average duration of symptoms until diagnosis is 2-6 months. Routine laboratory tests reveal peripheral blood leukocytosis (50%), increased ESR and C-reactive protein (70-80%). A typical radiological sign of COP is the presence of spotty, bilateral (less often unilateral) dense foci of consolidation of subpleural localization. In COP, migration of pulmonary infiltrates has been described, most often from the lower to the upper sections. The differential diagnosis of COP, in addition to bacterial pneumonia, is carried out with chronic eosinophilic pneumonia, bronchoalveolar cancer and pulmonary lymphoma.
Spontaneous improvement in COP has been described but is rare. The treatment of choice for COP is oral corticosteroids. Clinical improvement occurs within 1-3 days from the start of the first dose, radiological changes usually disappear after a few weeks, the total duration of GCS therapy ranges from 6 to 12 months. When the dose of GCS is reduced, relapses of the disease occur quite often; in this situation, the dose of steroids is increased again. The prognosis for COP is usually favorable; most patients are completely cured when taking GCS. However, in rare cases, there is a poor response to buy glucophage online and a steadily progressive course of COP. In such patients, the use of cytostatics is recommended.
Desquamative interstitial pneumonia (DIP) is a fairly rare disease from the IIP group. Among all patients with DIP, more than 90% were smokers. In addition, rare cases of DIP associated with other conditions - CTD, reactions to drugs, exposure to environmental factors - have been described. The clinical picture of the disease is typical for IIP. Laboratory, functional and radiological indicators for DIP do not provide additional information. If there is a questionable picture, a lung biopsy is recommended to exclude more aggressive forms of ILD. Quitting smoking is the first step in the treatment of DIP, as it has been shown that this measure often leads to reversal of the disease. For most patients with DIP, the main treatment is prednisolone therapy at a dose of 40-60 mg/day. The initial dose of prednisolone is usually prescribed for a period of 1-2 months, and then the dose of the drug is gradually reduced over 6-9 months. During GCS therapy, clinical improvement or stabilization of the disease is observed in approximately two thirds of patients with DIP. The significance of cytostatics in this form of IIP is not yet clear. The 5- and 10-year survival rates for DIP are 95.2 and 69.6%, respectively.
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Respiratory bronchiolitis associated with interstitial lung disease (RB-ILD) is a disease from the IIP group in which respiratory bronchiolitis is combined with damage to take glycomet pills and pulmonary interstitium.
This disease occurs in smokers with a smoking history of more than 30 packs/years. The average age of patients ranges from 30 to 40 years. The clinical picture and laboratory and instrumental examination data are typical for IIL.
Quitting smoking often leads to complete resolution of the disease; in some cases, small doses of corticosteroids may be required. The prognosis for RB-ILD is more favorable than for IPF, but still this disease in some cases can have a steadily progressive course and cause death in patients.
Lymphocytic interstitial pneumonia (LIP) is one of the most rare diseases from the IIP group. As the name suggests, the disease is based on widespread homogeneous lymphocytic infiltration of the pulmonary interstitium. The morphological diagnosis of LIP is very difficult, since some diseases associated with massive lymphocytic infiltration of lung tissue have a similar histological picture. pseudolymphoma, primary lymphoma, lymphomatous granulomatosis, etc.
LIP occurs most often in women, usually between the ages of 40 and 60 years. Most patients with LIP are non-smokers. The onset of the disease is most often unnoticed and gradual. The X-ray appearance of LIP is nonspecific.
To make a diagnosis of LIP, an open lung biopsy is required in all cases. The basis of LIP therapy is GCS. Doses and duration of therapy are approximately the same as for other cellular forms of IIP, such as DIP. Against the background of anti-inflammatory therapy, improvement or stabilization of the disease is observed in the majority of patients (about 80%), although in a small group of them there is a slow but steady progression of the disease. In addition to GCS, therapy with azathioprine, cyclophosphamide, methotrexate and cyclosporine was attempted in patients with LIP.
Acute interstitial pneumonia.
The first mention of AIP dates back to 1935, when Hamman and Rich described four patients with rapidly progressive respiratory failure, which led to the death of the patients within 6 months of the onset of the disease. At autopsy, severe widespread pulmonary fibrosis was found. For a long time, diseases with a chronic course (primarily IPF) were also called Hamman-Rich syndrome, but currently only UIP can be classified as Hamman-Rich syndrome.
In modern guidelines, AIP is considered as a disease characterized by progressive respiratory failure, leading in most cases to buy glycomet online. The clinical picture resembles acute respiratory distress syndrome (ARDS), but with AIP the cause of the disease is unknown and there is no involvement of other body systems in the process (multiple organ failure). Currently, about 150 cases of AIP are described in the world literature, which is associated not so much with the rarity of the disease, but with the complexity of its diagnosis.