Aspiration Pneumonia

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Overview of Aspiration Pneumonia
Correlation with Lung Involvement
Diagnosis of Aspiration Pneumonia

Prevention
Autoimmune Interstitial Pneumonia
Personal Stories

Overview of Aspiration Pneumonia

Aspiration pneumonia occurs when vomitus or reflux gets into the lungs, causing an often deadly form of pneumonia. Anyone (with or without scleroderma) can get aspiration pneumonia. It often occurs in systemic scleroderma patients due to esophagus problems.

Aspiration pneumonia is caused by breathing foreign materials (usually food, liquids, vomitvomit, or fluids from the mouth) into the lungs. This may lead to a collection of pus in the lungs (lung abscess); an inflammatory reaction; or a lung infection (pneumoniapneumonia). Medline Plus.

Shortness of Breath This worrisome symptom has many acute and chronic causes. Follow this flowchart for more information about the diseases in which shortness of breath occurs. familydoctor.org

Does Chronic Microaspiration Cause Idiopathic Pulmonary Fibrosis? Emerging data support a role for chronic microaspiration (i.e., subclinical aspiration of small droplets) in the pathogenesis and natural history of idiopathic pulmonary fibrosis. However, the precise relationship between chronic microaspiration and idiopathic pulmonary fibrosis remains unknown. Joyce S. Lee, MD Volume 123, Issue 4, Pages 304-311 (April 2010). (Also see: Pulmonary Fibrosis)

Correlation with Esophageal and Lung Involvement

Gastro-Esophageal Reflux and Pulmonary Fibrosis in Scleroderma: A Study Using pH-Impedance Monitoring. Systemic sclerosis (SSc) patients with interstitial lung disease (ILD) have more severe reflux, such as more reflux episodes and more reflux reaching the proximal esophagus. Whether or not the development of ILD in SSc patients can be prevented by reflux reducing treatments needs to be investigated. Wellsphere, Nov 2009.

Centrilobular Fibrosis: An Underrecognized Pattern in Systemic Sclerosis. The impressive association of lung involvement and gastroesophageal reflux in scleroderma raises the possibility of a cause-effect relationship. (UnBound MedLine) de Souza RB. e Respiration 2008 Sep 18. (Also see: Reflux)

Diagnosis of Aspiration Pneumonia

Symptoms include cough, coughing up sputum, and sometimes fever. The pneumonia will usually show up on chest x-ray, but a sputum culture will show that the pneumonia isn't caused by bacteria. Aspiration pneumonia should be suspected if a scleroderma patient has recurrent pneumonia. An estimated 30-50% of cases lead to death. However, mild cases may cause no symptoms at all.

Prevention of Aspiration Pneumonia

Preventive measures include carefully following your doctor's instructions for dealing with reflux (heartburn), such as taking medicines, elevating the head of the bed, and not eating near bedtime.

If you are instructed to elevate the head of your bed with bricks (a standard recommendation for reflux), do exactly that. Do not sleep sitting up, or propped up by several pillows, as this can worsen the problem by putting pressure on your stomach, thereby increasing the risk of aspiration pneumonia. See Reflux ISN.

Autoimmune Interstitial Pneumonia

A case of diffuse alveolar hemorrhage associated with interstitial pneumonia and systemic sclerosis. A necropsy specimen obtained from the left lung showed fibrosis, predominantly in peripheral areas of lobules, and accumulation of hemosiderin-laden macrophages, which findings were consistent with usual interstitial pneumonia and diffuse alveolar hemorrhage. We should be aware of this rare but serious complication in the management of interstitial pneumonia associated with systemic sclerosis. PubMed. Nihon Kokyuki Gakkai Zasshi. 2005 Jul;43(7):437-41. (Also see: Pulmonary Fibrosis)

Personal Stories about Aspiration Pneumonia

Bree: My Father Died from Aspiration Pneumonia I do not fully understand how or why this form of disease would cause a person to die...

Daphne: Daughter of Scleroderma/Polymyositis/Antisynthetase Syndrome Overlap Patient By early 2005, she began to exhibit Raynaud's phenomenon. She was also having swelling in her face, hands and feet...