Interstitial

Lung Disease
-Ashrifa.M
Roll no.12
Definition
Also known as Diffuse parenchymal lung
fibrosis.
Interstitial lung disease represents a large number
of heterogeneous disorders that involve the
parenchyma of the lung.
Classification
Pathogenesis
Clinical features
•Dyspnea on exertion
•Dry cough

•Pleuritic pain- Asbestosis

•Wheeze- Hypersensitive pneumonitis
•Fever+ arthralgia- Sarcoidosis
•Hemoptysis (rare)
 Signs
•Clubbing ++
•Velcro crackles- b/l bibasal fine crackles
>> differentiates from bronchiectasis

•Signs of pulmonary hypertension

*Elevated JVP
*RV heave
*Loud P2
*Ascites
*Hepatomegaly
Extrapulmonary signs
•Erythema nodosum – Sarcoidosis
•Subcutaneous nodules–Rheumatoid arthritis
•Raynaud’s - Systemic sclerosis
Investigations
•Chest X ray
-Nodules
-Diffuse ground glass opacities
-Consolidation
• High resolution CT scan
*Reticular shadows
*Linear shadows
*Nodules
*Honeycombing
*Tractional bronchiectasis
•Pulmonary function tests
Reduced lung volumes
Reduced diffusing capacities(DLCO)
Normal FEV1 to FVC ratio
•Arterial blood gas analysis
•Bronchoscopic studies
Bronchoalveolar lavage
•Lung biopsy
Transbronchial biopsy
Open-lung or thoracosopic biopsy
Treatment
Aims:
1. To remove exposure to injurious agents
2. To suppress inflammation to prevent further
destruction of the pulmonary parenchyma
3. Treat the underlying cause
Drugs
•Corticosteroids: to suppress the inflammation.
Prednisolone 0.5mg/kg o.d for 4-12 weeks
•N-Acetylcysteine 600mg thrice daily
•Other immunosuppresants: Cyclophosphamide
or Azathioprine
•Pirfenidone: antifibrotic drug
•Nintedanib:slows down the disease progression