Proteinaceous edema fluid

A greater degree of inflammation can lead to permanent lung damage or death. The respiratory bronchioles become obliterated (bronchiolitis obliterans), the alveoli are filled with proteinaceous edema fluid (heavy, wet lungs), and the inflammatory process can turn into interstitial fibrosis. 

Pulmonary infiltrates with eosinophilia (Loeffler s syndrome) have been associated with nitrofurantoin,para-aminosalicytic acid, methotrexate, sulfonamides, tetracycline, chlorpropamide, phenytoin, NSAIDs, and imipramine (Table 29-5). The disorder is characterized by fever, nonproductive cough, dyspnea, cyanosis, bilateral pulmonary infiltrates, and eosinophilia in the blood. Lung biopsy has revealed perivasculitis with infiltration of eosinophils, macrophages, and proteinaceous edema fluid in the alveoli. The symptoms and eosinophilia generally respond rapidly to withdrawal of the offending drug. 

Under normal conditions, the alveolar epithelial and endothelial cell layers that make up the air-blood barrier control the passage of fluids and cells between the air spaces of the lung and the interstitium. Damage to this delicate barrier can cause an inflammatory response and the impairment of lung function. Changes in the permeability of the alveolarcapillary barrier lead to an infusion of proteinaceous serous fluid (edema) and blood cells (neutrophils, macrophages, and eosinophils). This influx of cells usually peaks within the first 3-7 days of the inflammatory response. If the inflammation is sustained it is... 

Rat (Fischer-344) 4 hr Resp 200 M (increase in protein and lactate dehydrogenase in lavage fluid focal areas of perivascular edema proteinaceous material in the alveoli) Green et al. 1991... 

Pulmonary lesions. Acute pulmonary edema in swine is characterized by marked to massive intralobular pulmonary edema and marked hydrotiiorax. The lungs are distended and turgid arid die thoracic cavity is filled witfi straw-colored proteinaceous fluid. Microso> Mcally, the edema is primarily interstitial int obular in nature. 

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