IPS

 Q: "Idiopathic pneumonia syndrome" (IPS) is an/a? (select one) 

A) infectious entity 

B) noninfectious entity

Answer: B

IPS is seen mostly after hematopoietic cell transplantation (HCT). It is more common in allogeneic HCT. It is described as a clinical syndrome evident as widespread alveolar injury and clinical presentation of pneumonia. Patients usually require supplemental oxygen. It is probably a form of interstitial pneumonitis and/or diffuse alveolar damage. It has a very high mortality. There are three basic requirements to qualify for IPS

• widespread alveolar injury with symptoms and signs of pneumonia 
•  absence of active lower respiratory tract infection

Some experts have added a third criteria i.e., absence of cardiac, renal or any other iatrogenic etiology

#oncology

#pulmonary

References:

1. Fukuda T, Hackman RC, Guthrie KA, et al. Risks and outcomes of idiopathic pneumonia syndrome after nonmyeloablative and conventional conditioning regimens for allogeneic hematopoietic stem cell transplantation. Blood 2003; 102:2777

2. Clark JG, Hansen JA, Hertz MI, Parkman R, Jensen L, Peavy HH. NHLBI workshop summary. Idiopathic pneumonia syndrome after bone marrow transplantation. Am Rev Respir Dis. 1993;147(6, pt 1):1601–1606 2. 

3. Panoskaltsis-Mortari A, Griese M, Madtes DK, et al. American Thoracic Society Committee on Idiopathic Pneumonia Syndrome. An official American Thoracic Society research statement: noninfectious lung injury after hematopoietic stem cell transplantation: idiopathic pneumonia syndrome. Am J Respir Crit Care Med. 2011;183(9):1262–1279. 

4. David S. Wenger, Matthew Triplette, et. al. Incidence, Risk Factors, and Outcomes of Idiopathic Pneumonia Syndrome after Allogeneic Hematopoietic Cell Transplantation Biol Blood Marrow Transplant. 2020 Feb; 26(2): 413–420. Published online 2019 Oct 9. doi: 10.1016/j.bbmt.2019.09.034