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[Giant cell interstitial pneumonia without exposure to hard metals].

We describe the case of a 58-year-old woman with giant cell interstitial pneumonia without any history of exposure to hard metals. Giant cell interstitial pneumonia (GIP) is a rare interstitial lung disease characterized by the presence of numerous multinucleated giant cells in the alveolar spaces. Currently GIP is regarded as secondary interstitial pneumonia. While it has become almost synonymous with hard metal lung disease (cobalt pneumonitis), the literature has also included sporadic cases of GIP without exposure to hard metals. This fact undermines the synonymical relationship between GIP and hard metal lung disease. The alteration of lung tissue in GIP is immunologically mediated. In our patient we found a classical histological picture of GIP with lymphoid hyperplasia. At the time of diagnosis she was being treated for Hashimoto´s thyreoiditis. Later, autoimmune hemolytic anemia and bronchial asthma developed. We suggest that our case supports the hypothesis of the autoimmune ethiology of idiopathic GIPs.