Interstitial Lung Disease Flashcards
What is interstitial lung disease?
Diffuse fibrosis of the lung parenchyma. Impairs gas transfer and causes VQ mismatching. Fibrosis may be the result of inflammation (alveolitis and interstitial inflammation) or granulomatous disease.
What are the broad aetiology categories of interstitial lung disease?
- Idiopathic (idiopathic interstitial fibrosis)
- Secondary to disease of unknown aetiology (sarcoidosis, CT disease).
- Inhalation of mineral dusts (focal fibrosis)
- Replacement of lung tissue following disease that damages the lungs (e.g. aspiration pneumonia, TB)
What are the unknwon causes of ILD secondary to alveolitis?
What are the known causes of ILD secondary to alveolitis?
- Asbestosis
- Radiation injury
- Aspiration pneumonia
- Drugs (e.g. amiodarone)
What are the known and unknown causes of ILD secondary to granulomatous diseases?
Unknown Cause
- Sarcoidosis
- Wegener’s disease; Churg Strauss disease
Known Cause
- Hypersensitivity pneumonitis to organic or inorganic dusts (silica, beryllium).
What are the 3 most important features of ILD?
What are the signs of ILD?
- General: dyspnoea, cyanosis, clubbing
- Palpation: expansion slightly reduced
- Auscultation: fine (velcro like) inspiratory crackles, late or pan-inspiratory
- Signs of associated CT disease: RA, SLE, scleroderma, Sjogren’s syndrome, polymyositis, dermatomyositis.
What are the causes of upper lobe predominant ILD?
SCART:
Silicosis (progressive massive fibrosis), sarcoidosis
Coal Workers’ pneumoconiosis (progressive massive fibrosis), CF, chronic allergic alveolitis, chronic eosinophilic pneumonitis.
Ankylosing spondylitis, ABPA, alveolar haemorrhage syndromes
Radiation
What are the causes of lower lobe predominant ILD?
RASIO
RA, other collagen vascular disease
Asbestosis, acute allergic alveolitis, acute eosinophilic pneumonitis
Scleroderma
Idiopathic pulmonary fibrosis
Other (drugs)
