Desquamative Interstitial Pneumonia
Desquamative interstitial pneumonia is chronic lung inflammation that occurs in current or former cigarette smokers.
Although the word "pneumonia" is used, there is no evidence that an infection causes the inflammation. The condition affects cigarette smokers in their 30s and 40s, with most people developing breathlessness with even minimal exertion.
A chest x-ray shows less severe changes than in idiopathic pulmonary fibrosis and may show no changes in up to 10% of people. Pulmonary function tests show a decline in the amount of air contained in the lungs at the end of a person's strongest effort to breathe in (maximal inspiration). The amount of oxygen in a blood sample is low.
A lung biopsy is often needed to confirm the diagnosis and usually shows a distinctive pattern of diffuse and uniform lung inflammation. The most striking feature is the presence of numerous macrophages (cells that clear the alveoli of small inhaled particles and bacteria) within most of the smallest airways (bronchioles) and the alveoli.
About 70% of people who have desquamative interstitial pneumonia survive for 10 years or longer; the response is even better when the person stops smoking and takes corticosteroids.
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