Interstitial Lung Disease

Question 1

What is pulmonary sarcoidosis? How does it present?

Investigations? Treatments?

Answer 1

Where there is alveolitis
Presents as a dry cough, breathlessness, can also be accompanied by patches of redness on the skin, hypercalcaemia

Investigate: CXR, ct scan of lungs, tissue biopsy, blood test (inflammatory markers, angiotensin converting enzyme- regulates BP by fluid control)

Treat: steroids (prednisolone), immunosuppression

Question 2

What is Extrinsic allergic alveolitis? (Hypersensitivity pneumonitis)
What kind of hypersensitivity reaction is it?
Presentation for both types?
Treatments?

Answer 2

Where there is inflammation of the alveoli

• type III hypersensitivity reaction where immune complexes form and deposit in the lung causing inflammation.
• triggers like bird fanciers lung or farmers lung

Acute= cough, breathless, fever, malagia, cxr with inflitrates

Chronic= progressive cough, breathlessness

Treatment is antigen avoidance and steroids

Question 3

What is idopathic pulmonary fibrosis?
Presentation?
Treatment?

Answer 3

Scarring of lungs due to imbalance of fibrotic repair system

• progressive breathlessness, dry cough, clubbing, crackes bilateral- cxr bilateral infiltrates, ct scan shadowing and honeycombing
• treat symptoms as scaring is permanent. Using pirfenidone and nintedanib (also used for SCLC)