Overview
Signs of Interstitial Lung Disease
General Signs
- Dry cough
- Cyanosis
- Reduced chest expansion
- Crepitations - fine, end-expiratory
Signs Suggesting a Cause
- Symmetric arthropathy (rheumatoid arthritis)
- Skin thickening (scleroderma)
- Lymphadenopathy (sarcoidosis)
Signs of Complications
- Cor pulmonale - raised JVP, ascites, pleural effusions, peripheral oedema
- Pulmonary hypertension - prominent a wave, parasternal heave, loud / palpable P2
Pathogenesis
Causes of Interstitial Lung Disease
ILD of Known Association
- Connective tissue disease - rheumatoid arthritis, scleroderma, systemic lupus erythematosus, Sjogren's syndrome, polymyositis / dermatomyositis
- Medications - methotrexate, nitrofurantoin, bleomycin
- Occupational exposure - silicosis, asbestosis
Granulomatous ILD
- Sarcoidosis
- Hypersensitivity pneumonitis
Idiopathic Interstitial Pneumonias
- Idiopathic pulmonary fibrosis
- Others - idiopathic non-specific interstitial pneumonia, acute interstitial pneumonia, cryptogenic organising pneumonia, lymphocytic interstitial pneumonia, desquamative interstitial pneumonia
Complications
Complications of Interstitial Lung Disease
- Acute exacerbation of ILD
- Cor pulmonale
- Pulmonary hypertension
- Lung cancer
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