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Epidemic acute interstitial pneumonia in children occurred during the early 2006s

Korean Journal of Pediatrics 2008;51(4):383-390.
Published online April 15, 2008.
Epidemic acute interstitial pneumonia in children occurred during the early 2006s
Chong Kun Cheon1, Hyun-Seung Jin1, Eun Kyeong Kang2, Hyo Bin Kim3, Byoung-Joo Kim1, Jinho Yu1, Seong Jong Park1, Soo-Jong Hong1, June Dong Park1
1Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
3Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea
2006년 초에 유행한 소아 급성 간질성폐렴
전종근1, 진현승1, 강은경2, 김효빈3, 김병주1, 유진호1, 박성종1, 홍수종1, 박준동1
1울산대학교 의과대학 서울아산병원 소아과학교실
2서울대학교 의과대학 소아과학교실
3인제의대 상계백병원 소아과학교실
Correspondence: 
June Dong Park, Email: jdparkmd@sna.ac.kr
Abstract
Purpose
: This study was aimed to analyze the clinical characteristics of patients with acute interstitial pneumonia who had presented similar clinical patterns from March to June, 2006 and to describe our experience of treatment and to identify risk factors associated with prognosis.
Methods
: The clinical characteristics, radiologic and histopathologic findings and response to steroids of 15 patients (non-survival group [n=7] and survival group [control, n=8]) with acute interstitial pneumonia were investigated through the review of medical records.
Results
: The mean age of the patients was 26 (range: 3-48) months. Cough, cyanosis and fever were frequent symptoms. The most frequent radiologic findings on admission were pneumomediastium and extensive ground glass opacity. Surgical lung biopsy was performed on 8/15 (53.3%) patients and diffuse alveolar damage was found. Mechanical ventilation was applied for 9/15 (60.0%) patients for 40 (range: 1-99) days. Five patients in survival group received steroid treatment and 7 patients in non-survivial group (P=0.20). One patient in survival group received steroid pulse treatment and 4 patients in non-survival group (P=0.12). Seven patients died all of respiratory failure. The survival rate was 53.4%.
Conclusion
: The patients with acute interstitial pneumonia which occurred on spring 2006 showed high mortality because of rapidly and extensively progressing pulmonary fibrosis and air leakage. Therefore, we should consider surgical lung biopsy and steroid application earlier. We should recognize this acute interstitial pneumonia occurring on spring in domestics and need to investigate the cause and treatment in large scale.
Key Words: Acute interstitial pneumonia, Histopathology, Corticosteroid, Pneumomediastinum


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