This entire historical complex begins to assume a rather specific pathogenetic structure that must be recognized if effective therapy for what appears as a motley group of diseases is to be effective. The fact remains that it is not an untenable hypothesis that this entire group of disease states is closely related to surfactant depletion from whatever cause. It is possible to associate these as related entities, whether they be hyaline membrane disease of the newborn, bronchopulmonary dysplasia, osygen or chemotherapeutic-drug toxicity of the lungs, radiation pneumonitis, UIP, Hamman-Rich syndrome, or ESL. It is probable also that pulmonary embolism, infarction, extracorporeal circulation, chest and other trauma, and surgery as it affects the circulation of the lung are probably also closely related. Infections such as viruses, Proteus, Pseudomonas, and Aerobacter may be either secondary or primary in producing these disease manifestations. It is further probable that the pulmonary dysmaturity of Wilson-Mikity is also very closely related, representing a developmental deficiency not too dissimilar from hyaline membrane disease of the newborn. In a symptomatic way the therapy may involve PEEP, corticosteroids, high doses of vitamin E as free-radical scavenger, glutathione or other sulfhydryl-related compounds, or some of the other biochemical suggestions made. The common denominator is apparently the disruption of the pulmonary-surfactant mechanism. These disease processes, as shown in the above radiologic and pathologic illustrations, are indeed 'look-alikes' because in all instances there is a surfactant depletion (even though it be the dipalmitoyl lecithin component primarily which is deficient), yet the etiologies are widely dissimilar.
|Original language||English (US)|
|State||Published - Jan 1 1979|
ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging