Intensive Care Medicine

, Volume 4, Issue 4, pp 181–191 | Cite as

Acute interstitial pulmonary fibrosis

Comparative light and electron microscopic study of 19 cases pathogenic and therapeutic implications
  • A. Porte
  • M. E. Stoecke
  • J. M. Mantz
  • J. D. Tempe
  • A. Jaeger
  • A. Batzenschlager
  • J. Hauss
Original Articles

Abstract

Comparative light and electron microscopic studies of the lung were performed in 19 cases of diffuse acute interstitial fibrosis with various etiologies. Our observations emphasize the relation between hyaline membranes (HM) and the evolution of fibrosis. HM formation is due to fibrinous exudates and epithelial necrosis. This phenomenon recurs during the evolution of the disease and appears to be responsible for new waves of fibrosis. Its pathogenesis (humoral or neurovascular ...) remains hypothetical. Modifications of the alveolar epithelium consecutive to septal fibrosis can be clearly distinguished from “fibrinoid necrosis”-type lesions, which result in HM. The formation of HM is accompanied by fibroblastic stimulation which proceeds in spite of epithelial renegeration. The exact stimulus for the proliferation and collagen hypersecretion of fibroblasts remains to be determined. The use, in association with corticosteroid treatment, of a structural analogue of L lysine, acexamic acid, to impede collagenesis reveals encouraging perspectives for improved therapy.

Key words

Pulmonary fibrosis Electron microscopy Fibrinous exudates Hyaline membranes Treatment with acexamic acid 
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Copyright information

© Springer-Verlag 1978

Authors and Affiliations

  • A. Porte
    • 1
  • M. E. Stoecke
    • 1
  • J. M. Mantz
    • 2
  • J. D. Tempe
    • 2
  • A. Jaeger
    • 2
  • A. Batzenschlager
    • 3
  • J. Hauss
    • 4
  1. 1.Institut de Physiologie (Section Sciences)Université Louis PasteurStrasbourgFrance
  2. 2.Service de Réanimation Médicale, C.H.U.Université Louis PasteurStrasbourgFrance
  3. 3.Institut d'Anatomie Pathologique, C.H.U.Université Louis PasteurStrasbourgFrance
  4. 4.AllgemeinchirurgieChirurgische Klinik und Poliklinik der UniversitätMünsterFederal Republic of Germany

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