Interstitial Lung Diseases Clinical Features examination Treatment

Interstitial Lung Diseases

• A large group of diseases with different causesAyurveda Drugs MANDUKPARNI CENTELLA ASCIATICA Specifically work on the Central Nervous System. Read more ... » but with the same or similar clinicalRenin and Hypertension Low renin and High Renin essential hypertension with Treatment. Read more ... » and pathological changes.
• The interstitial lung diseases (ILD) are diseases of lung parenchyma/ alveoli/ alveolar epithelium/ capillary endothelium/ and the spaces between These structures/ perivascular and Imphatic tissues.
• These are due to chronicChronic Hepatitis Classification viral hepatitis Clinical features and Treatment. Read more ... », nonmalignant, noninfectious diseases of the lower respiratory tract characterized by inflammation and disruption of the walls of the alveoli.
• Diffuse parenchymal lung diseases, often collectively referred to as the interstitial lung diseases (ILDs), are a heterogeneous group of disorders that are classified together because of similar clinical, roentgenographic, physiologic, or pathologic manifestations (show table ) .
• This manifests clinically as a limitation in the ability of the lungs to transfer oxygen from the alveoli to the pulmonary capillary bed.
• However, the term interstitial is misleading, since most of these disorders are also associated with extensive alteration of alveolar and airway architecture.
• Patients with these disorders are dyspneic first in connection with exercise and, later, as the diseaseRenin and Hypertension Low renin and High Renin essential hypertension with Treatment. Read more ... » progresses, even at rest.
• There is diffuse parenchymal lung involvement, con­nective tissue involvement, and either fibrosis or granuloma formation. The cause may be known or unknown.
•  The disease may have 2 phases - AcuteRenin and Hypertension Low renin and High Renin essential hypertension with Treatment. Read more ... » & Chronic phase. The disease is usually recurrent.
• Interstitiai C1iseases of unknown etiology SarcoidosisSarcoidosis Causes Diagnosis Symptoms and Treatment. Read more ... »,’Idiopathic pulmonary fibrosis, Wegener’s granulomatosis, SLE, rheumatoid arthritis, tioodpasture’s syndromeMetabolic,Insulin Resistance Syndrome X Causes Symptoms. Read more ... ».
• Interstitial diseases of known etiology Asbestos, drugs like amiodarone, antibiotic, gold, hypersensitivit neumonitis.

Clinical Features of Interstitial Lung Diseases

• Presentation may be acute, sub-acute or chronic. Age commonly affected is 20 – 40 years.
• There may be a family history of interstitial lung dis­ease.
• Some diseases are more common in women but pneu­moconfosis is mOre common in men.
• ILD is very common in smokers.
• SymptomsRenin and Hypertension Low renin and High Renin essential hypertension with Treatment. Read more ... » are dyspnoea, wheezing, substernal dis­comfort, chest painApproach to Chest Pain Differential diagnosis of chest pain. Read more ... », hemoptysis, fatigueFatigue diagnosis medicine and treatment. Read more ... », weight loss .

Interstitial Lung Diseases  Physical examinationHow to take good medical history & examination. Read more ... »

• Tachypnoea, bilateral basal inspiratory crackles, Wheeze, cyanosis, and clubbing.

Lab diagnosis

• ANA (Antinuclear antibodes), anti immuno globulin antibodies, circulating immune complexes, anti-base­ment anti~6dies=-serum _Rr~ciRitins in hypersensitivity pneumonitisHYPERSENSITIVITY PNEUMONITIS Clinical features Diagnosis and Treatment of Hypersensitivity. Read more ... ».

X-RAY

• Bilateral basal reticular pattern.
• Nodular opacities especially in upper zones. -)Honey-combing.
• Progressive changes of fibrosis.

CT - HRCT

• CT and High resolution CT for early detection and con­firmation.

Pulmonary function test

• SpirometryComplete Management of COPD. Read more ... » and lung volumes show a restrictive de­fect with reduced total lung capacity, reduced FEV₁ and FVC, increased FEV₁ j FVC.

Diffusing capacity

• There is reduction in diffusing capacity for carbon monoxide in ILDs.

Arterial blood gases

• May be normal, or show hypoxaemia, respiratory al­kalosis, hypocapnia, normocapnia, and rarely hyper­capnia.

Fiberoptic bronchoscopy and bronchoalveolar la­vage

• Is useful for diagnosisRenin and Hypertension Low renin and High Renin essential hypertension with Treatment. Read more ... » of sarcoidosis, hypersensitiv­ity pneumonitis.

Treatment of Interstitial Lung Diseases

•   Removal of stimulus
• Suppression of inflammation
• Supplemental oxygen
•  Glucocorticoids-Prednisone 1 mg/kg once daily’ orally for 4-12 wks.
•   Cyclophosphamide and Azathioprine 0,/ Lung transplantation.