All issues > Volume 51(4); 2008

Original Article

Korean J Pediatr. 2008;51(4):383-390. Published online April 15, 2008.

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

Chong Kun CK Cheon¹, Hyun-Seung HS Jin¹, Eun Kyeong EK Kang², Hyo Bin HB Kim³, Byoung-Joo BJ Kim¹, Jinho JH Yu¹, Seong Jong SJ Park¹, Soo-Jong SJ Hong¹, June Dong JD 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

Correspondence June Dong JD 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.

Keywords :Acute interstitial pneumonia, Histopathology, Corticosteroid, Pneumomediastinum