Hamman-Rich syndrome medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2]

Overview

There is no effective treatment for acute interstitial pneumonitis, Management in general includes supportive therapy and administration of glucocorticosteroids and Immunosuppressive agents.

Supportive care

Patients with acute interstitial pneumonitis receive supportive care alongside the medical therapy^[1]:
- Supplemental oxygen
- Mechanical ventilation
- Measures to be taken to relieve symptoms (eg, dyspnea, anxiety, cough)
- Prevention of complications
  - Venous thromboembolism
  - Gastrointestinal bleeding
  - Hospital-acquired pneumonia
  - Secondary pulmonary hypertension
  - Anemia
  - Sepsis
Pulmonary rehabilitation (eg, patient education, optimal exercise program)
Maintain ideal body-mass index
- Reduction of weight if obese
- Nutritional support if the patient is cachectic
Vaccination against possible causes of pulmonary inflammation as influenza and pneumococcal vaccines.^[2]

Medical Therapy

Corticosteroid therapy:^[3]
- Once the diagnosis of acute interstitial pneumonitis is confirmed, high doses of glucocorticosteroids (eg, methylprednisolone) should be administered.
- Monitor the patient for glucocorticosteroid-induced side effects (eg, hyperglycemia, increased susceptibility to infection, gastritis).
Immunosuppressive therapy

References

↑ Suh GY, Kang EH, Chung MP, Lee KS, Han J, Kitaichi M, Kwon OJ (March 2006). “Early intervention can improve clinical outcome of acute interstitial pneumonia”. Chest. 129 (3): 753–61. doi:10.1378/chest.129.3.753. PMID 16537878.
↑ Tomczyk S, Bennett NM, Stoecker C, Gierke R, Moore MR, Whitney CG, Hadler S, Pilishvili T (September 2014). “Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP)”. MMWR Morb. Mortal. Wkly. Rep. 63 (37): 822–5. PMC 5779453. PMID 25233284.
↑ Avnon LS, Pikovsky O, Sion-Vardy N, Almog Y (January 2009). “Acute interstitial pneumonia-Hamman-Rich syndrome: clinical characteristics and diagnostic and therapeutic considerations”. Anesth. Analg. 108 (1): 232–7. doi:10.1213/ane.0b013e318188af7a. PMID 19095855.

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[pmid16537878-1] Suh GY, Kang EH, Chung MP, Lee KS, Han J, Kitaichi M, Kwon OJ (March 2006). “Early intervention can improve clinical outcome of acute interstitial pneumonia”. Chest. 129 (3): 753–61. doi:10.1378/chest.129.3.753. PMID 16537878.

[pmid25233284-2] Tomczyk S, Bennett NM, Stoecker C, Gierke R, Moore MR, Whitney CG, Hadler S, Pilishvili T (September 2014). “Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged ≥65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP)”. MMWR Morb. Mortal. Wkly. Rep. 63 (37): 822–5. PMC 5779453. PMID 25233284.

[pmid19095855-3] Avnon LS, Pikovsky O, Sion-Vardy N, Almog Y (January 2009). “Acute interstitial pneumonia-Hamman-Rich syndrome: clinical characteristics and diagnostic and therapeutic considerations”. Anesth. Analg. 108 (1): 232–7. doi:10.1213/ane.0b013e318188af7a. PMID 19095855.

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