Desquamative interstitial pneumonia (DIP) is a type of non-infectious pneumonia known as idiopathic interstitial pneumonia. It can also be called alveolar macrophage pneumonia (AMP), the difference with DIP being that increases in macrophage cells are found. An increase in these cells triggers an immune system response. Interstitial inflammation occurs, which is a type of inflammation that causes tissue destruction.
Idiopathic interstitial pneumonia is classified as an interstitial lung disease. Desquamative interstitial pneumonia is a rare form of this disease. Its main distinguishing symptom is increased macrophages. Macrophage cells are created by monocytes, which are types of white blood cells with the purpose of destroying foreign antigens and damaged cells. Due to the interstitial inflammation that occurs from the pneumonia, cells and tissues in the lungs are damaged. These damaged parts become a target for macrophages.
Desquamative interstitial pneumonia causes are most commonly related to smoking. Most commonly, patients diagnosed with DIP are younger, averaging about 36 to 46 years old. Additionally, the patients have usually been smoking heavily for several years.
Similar to idiopathic interstitial pneumonia, DIP symptoms include chronic dry coughing, weight loss, and chest pain. Patients will often also experience shortness of breath and other difficulty breathing. Some patients have a persistent low-grade fever as well.
Diagnosing desquamative interstitial pneumonia involves testing that allows doctors to view the inside of the lungs. Imaging tests can provide pictures of the lungs that are needed. These tests can include magnetic resonance imaging and ultrasounds. One of the defining results that appears on images is the large presence of macrophages that are brownish in color and show in the air spaces of the alveoli in the lungs.
DIP treatment involves efforts for long-term control of the disease and short-term management of symptoms. DIP control is achieved through treatment with prescription corticosteroids. Oxygen therapy can be used in the short-term to help with sporadic flare-ups that cause breathing problems, or it can be used long-term when breathing has become permanently compromised. Over-the-counter medications can help relieve some symptoms, such as the dry coughing.
There is no current cure for desquamative interstitial pneumonia. Supportive medicine can help patients reduce the frequency and severity of symptoms that are experienced. Managing symptoms can help improve the quality of life and expand life expectancy, provided that treatment is started quickly and continues. Without treatment, a patient with this lung disease cannot expect to be comfortable or live beyond a few years.
