Ver el código de «Interstitial lung disease»

==Background==
[[File:Lung and diaphragm.jpg|thumb|Lobes of the lung with related anatomy.]]
* General group of diseases that involve the scarring of lung parenchyma
* Grouped together because of similar clinical, physiologic, radiographic, or pathologic findings 
* Specific diseases separated into ones with known causes and idiopathic 
* Treatment and prognosis differs between specific diseases
* Examples of specific diseases:
**Interstitial pneumonia
**Hypersensitivity pneumonitis
**Cryptogenic organizing pneumonia
**Acute interstitial pneumonitis
**[[Sarcoidosis]]
**[[Idiopathic pulmonary fibrosis]]

==Clinical Features==
* Symptoms
**Progressive exertional [[dyspnea]]
**Persistent, nonproductive [[cough]]
*+/- [[hemoptysis]], pleuritic [[chest pain]]
* May have history of smoking, occupational exposures (asbestosis, silicosis, grain dust, bird droppings), medications that can cause pulmonary damage, connective tissue disease, IBD
*Physical exam
**Usually nonspecific
**Increased work of breathing, [[hypoxia]]
**+/- Abnormal lung sounds (classically fine, "velcro-like" crackles)

==Differential Diagnosis==

{{Pulmonary fibrosis differential}}

{{SOB DDX}}

==Evaluation==
*Definitive diagnosis of ILD rarely made in the ED
*ED workup should focus on assessing for reversible pathologies that may be causing or exacerbating symptoms (e.g. infection, [[PE]], [[pulmonary hypertension]], [[pulmonary edema]], concomitant [[COPD]] exacerbation, etc.) 
**VBG/ABG
**CBC, BMP
**[[CXR]]
**Consider CT chest (to rule out PE or better characterize lung parenchyma)
**+/- Infectious workup, echo as appropriate
*Inpatient/outpatient workup may include serologic studies (ANA, rheumatoid factor), PFTs, BAL, lung biopsy

==Management==
*Treat underlying/exacerbating factors (e.g. antimicrobials for infection, optimize volume/hemodynamics for pulmonary hypertension patients, bronchodilators for concomitant obstructive lung disease)
*Support [[oxygen therapy|oxygenation]] and [[ventilation]]
*Specific disease treatments vary, but many respond to [[steroids]], sometimes at high doses
**See management section of [[idiopathic pulmonary fibrosis]]

==Disposition==
* Low threshold to admit 

==See Also==
* [[Sarcoidosis ]]
* [[Idiopathic pulmonary fibrosis]]
* [[Pneumoconiosis]]
* [[Hypoxia]]
* [[Dyspnea]]

==References==
<references/>

[[Category:Pulmonary]]