Interstitial Lung Disease Flashcards
two categories of interstitial lung disease
- granulomatous ILD
2. idiopathic interstitial pneumonia
two examples of granulomatous ILDs
- sarcoidosis
2. extrinsic allergic alveolitis
define sarcoidosis
this is a type 4 hypersensitivity reaction which leads to the presence of non-caseating granulomas
presentation of sarcoidosis
- erythema nodosum
- bilateral hilar lymphadenopathy
- weight loss
- uveitis
- fever
- lung infiltrates (chronic)
diagnosis of sarcoidosis
- spirometry shows restrictive defect
- CXR (eggshell calcification)
- high resolution CT (ground-glass appearance)
- biopsy from lymph nodes if present
- bloods raised ACE, Ca2+ and inflammatory markers
management of sarcoidosis
- steroids e.g. prednisolone or budesonide
- oxygen
define extrinsic allergic alveolitis
this is hypersensitivity pneumonitis, a type 3 hypersensitivity reaction where immune complexes are deposited due to the presence of thermophilic, avian agents or certain drugs
presentation of EAA
- cough
- breathless
- pyrexia
diagnosis of EAA
- CXR (pulmonary infiltrates)
- precipitins IgG antibodies in serum
- spirometry is restrictive
- DLCO is decreased
management of EAA
- removal of antigen exposure
- steroids e.g. prednisolone
example of a idiopathic interstitial pneumonia
idiopathic pulmonary fibrosis
what is idiopathic pulmonary fibrosis
progressive scarring of the lungs
presentation of idiopathic pulmonary fibrosis
- SOB
- dry cough
- fine inspiratory crackles
diagnosis of IPF
- spirometry is restrictive
- CXR (bilateral infiltrates + ground glass appearance)
- CT (fibrotic shadowing)
- honey-comb cystic changes
management of IPF
steroids and immunosuppressants antifibrotic drugs e.g. pirfenidone and nintedanib lung transplant (if young)
