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Lymphocytic interstitial pneumonia.

A S Teirstein1, M J Rosen

  • 1Mount Sinai School of Medicine, New York, New York.

Clinics in Chest Medicine
|September 1, 1988
PubMed
Summary

Lymphocytic interstitial pneumonia (LIP) is common in HIV-infected children, presenting with cough and lung infiltrates. Diagnosis requires lung biopsy, and while corticosteroids may help, other HIV complications are often fatal.

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Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Immunology

Background:

  • Lymphocytic interstitial pneumonia (LIP) is a recognized complication of Human Immunodeficiency Virus (HIV) infection.
  • While common in pediatric HIV cases, LIP is infrequent in adults.
  • Clinical presentation includes cough, dyspnea, diffuse pulmonary infiltrates, restrictive lung function, and hypoxemia, often mimicking Pneumocystis pneumonia (PCP).

Purpose of the Study:

  • To detail the clinical, radiographic, and histopathologic features of lymphocytic interstitial pneumonia (LIP) in the context of HIV infection.
  • To discuss the diagnostic challenges and potential pathogenesis of LIP in HIV patients.
  • To review treatment responses and prognosis for LIP in HIV-associated cases.

Main Methods:

  • Review of clinical case data and histopathologic findings from lung biopsies.
  • Immunohistologic analysis to characterize infiltrating lymphocytes in HIV-associated LIP.
  • Correlation of clinical presentation with diagnostic imaging and pulmonary function tests.

Main Results:

  • Microscopic examination reveals diffuse interstitial infiltration by lymphocytes and plasma cells.
  • Immunohistochemistry confirms these lymphocytes are T cells in HIV-infected individuals.
  • Patients may exhibit variable responses to corticosteroid therapy, with some improving spontaneously.

Conclusions:

  • Lymphocytic interstitial pneumonia (LIP) is a distinct pulmonary complication of HIV infection, particularly in children.
  • Diagnosis necessitates lung biopsy due to overlapping symptoms with other opportunistic infections like PCP.
  • The pathogenesis remains unclear, potentially involving Epstein-Barr virus (EBV) or direct HIV lung infection; prognosis is often poor due to other HIV-related complications.

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