Desquamative Interstitial Pneumonia
The case involves a 34-year-old woman who is a heavy smoker, obese, and has difficulty breathing and dry cough. She has chronic respiratory failure and low oxygen levels, despite receiving supplemental oxygen. The physical exam showed quiet breath sounds, and pulmonary function tests showed mild restriction and reduced diffusion capacity. Imaging of the chest revealed diffuse ground-glass opacities and areas of consolidation. A lung biopsy showed interstitial fibrosis and pigment-laden macrophages, consistent with desquamative interstitial pneumonia, a rare type of idiopathic interstitial pneumonia that is highly associated with cigarette smoking. Treatment with a smoking-cessation program and glucocorticoids was initiated. At the 3-month follow-up, the patient's symptoms remained unchanged as she continued smoking cessation.