1148 A First Case of Lymphocytic Interstitial Pneumonitis in Healthy Child

Wednesday, 14 October 2015
Hall D1 Foyer (Floor 3) (Coex Convention Center)

Ji-in Jung, MD , Department of Pediatrics, Dong-a University Hospital, Busan, South Korea

Ha-Su Kim, MD , Department of Pediatrics, Dong-a University Hospital, Busan, South Korea

Hyun-a Kim, MD , Dong-a University Hospital, Busan, South Korea

Jin-a Jung, MD, PhD , Department of Pediatrics, Dong-a University Hospital, Busan, South Korea

Introduction : Lymphocytic interstitial pneumonitis(LIP) is an uncommon histopathologic entity characterized by infiltration of the interstitium and alveolar spaces of the lung by lymphocytes, plasma cells and other lymphoreticular elements. LIP in children has been most commonly associated with human immunodeficiency virus(HIV) infection. We report a first case of LIP in a HIV-negative healthy adolescent.

Case Report : An 13-year-old boy represented with pneumonia on chest X-ray in routine health examination. He had no respiratory symptoms and there was no abnormal findings on physical examination, A chest CT showed multiple ill defined centrilobular nodules and peribronchial air space nodules with mild volume loss in RLL. There was no increase of IgG Mycoplasma pneumoniae antibody titer in 3 serial tests between 7 days interval. Tuberculin skin test and Tbc specific antigen induced interferon-gamma(IGRA) test were negative. Chest x-ray in regular intervals during 6 months showed improvement of pneumonic consolidation, but new pneumonic consolidation on other site. Therefore, open lung biopsy was performed, and it showed diffuse interstitial lymphocyte infiltrate. The lung tissue was negative for EBV by DNAPCR and EBV serology showed all-negative. Serum immunoglobulins were normal and autoimmune studies were negative. The total lymphocyte count and lymphocyte subset were normal. He was started on oral prednisone (1 mg/kg/day) for 2 months and the chest x-ray returned to normal. Then he was tapered oral prednisone for 2 months and follow-up chest CT showed no abnormal finding. He has been followed for 8 months after diagnosis without complications.

Conclusion : We report a first case of HIV-negative, EBV-negative LIP in a healthy child.