Diagnosis :
Interstisial Lung disease ( ILD ) ( also known Diffuse Parenchymal Lung Disease )
CC: SOB OR COUGH
Clinical signs:
Clubbing
Fine end-inspiratory crackles , at lower zones ( basal )
Reduced chest expansion
Causes of ILD?
Idiopathic:
Idiopathic pulmonary fibrosis
Or secondary :
Connective tissue related disease like RA, sarcoidosis, SLE, systemic sclerosis, dermatomyositis, …
Inhaled substances ( pneumoconiosis ) like asbestosis, silicosis, …
Drugs like nitrofurantoin, cigarette smoking, …
Extrinsic allergic alveolitis ( hypersensitivity pneumonitis ) due to exposure to birds, …
Cause of basal fibrosis :
Usual interstitial pneumonia
Asbestosis
Connective tissue disease
Aspiration
WHAT WILL YOU DO ?
CXR
ABG
SPIROMETRY
BASIC PROFILE LIKE CRP, ANA, ANCA, RF
HRCT CHEST
MANAGEMENT of pulmonary fibrosis:
NON PHARMACOLOGICAL
STOP SMOKING
NICOTINE REPLACEMENT THERAPY
PHARMACOLOGICAL
STEROID IF INFLAMMATORY
NAC
ANTIFIBROTIC AGENT LIKE PIRFENIDONE
SURGICAL
SINGLE LUNG TRANSPLANT
