Desquamative interstitial pneumonitis in a healthy non-smoker: A rare diagnosis

Abstract

Desquamative interstitial pneumonitis is an interstitial lung disease most commonly associated with smoking. It causes respiratory symptoms including indolent cough and dyspnea. Characteristic findings on computed tomography include bilateral ground-glass opacities, septal thickening and preserved structure. Diagnosis is made by tissue sampling, which classically demonstrates alveolar macrophages, and thickened alveolar septa with an eosinophilic infiltrate lined with hyperplastic type II pneumocytes. Treatment is immune suppression with steroids or other agents, and avoiding the causal agent. The case reported describes a 27-year-old woman with no smoking history who worked in a potato chip factory, presenting with cough, dyspnea and dizziness. The patient had characteristic findings on imaging and was diagnosed via biopsy with desquamative interstitial pneumonitis. She improved clinically with reduced exposure and steroid therapy. While food production workers are at risk for respiratory illness, there are no reported cases of desquamative interstitial pneumonitis in this setting. ©2014 Pulsus Group Inc. All rights reserved.