Interstitial Lung Disease Flashcards
What happens (in general) in interstitial lung disease?
Inflammation and fibrosis of the interstitium
What is the lung interstitium?
The potential space between the alveolar epithelium and capillary endothelium
What cells are involved in ILD?
Epithelial Endothelial Mesenchymal Macrophages Recruited inflammatory cells
What type of deficit is ILD? Restrictive or obstructive? How?
Restrictive
-makes lungs less compliant due to development of the fibrous tissue
How is airway resistance affected in ILD?
It isn’t
Can sometimes be increased
What impairs gas exchange in ILD?
The lengthened diffusion pathway between alveolar air and blood impairs gas exchange
Clinical features of ILD?
4 D's Dry cough Progressive dyspnoea Digital clubbing Diffuse inspiratory crackles
Reduced exercise tolerance Tachypnoea Tachycardia Bilateral reduced chest movement Cyanosis and signs of right heart failure
Common general causes of ILD?
Occupational Treatment relayed Connective tissue disease Immunological Idiopathic
What are lung function results?
Show restrictive patterns.
FEV1/FVC is normal (>70%)
What is fibrosing alveolitis?
A progressive inflammatory condition of the lungs
Cause unknown
What happens histologically in fibrosing alveolitis?
Activated alveolar macrophages attract neutrophils and eosinophils
Lung damage due to ROS and proteases
Causes tissue destruction and fibrosis
Symptoms of fibrosing alveolitis?
Shortness of breath
Dry cough
Finger clubbing
What is seen on a CXR of fibrosing alveolitis?
Small lungs
Micro-nodular shadowing in lower lobes
Ragged heart borders
How is fibrosing alveolitis managed?
High dose oral steroids
Less effective once fibrosis has developed
What is extrinsic alveolitis?
A condition which results from repeated exposure to antigens of which the individual has been sensitised?