Interstitial lung disease

Background

General group of diseases that involve the 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

Symptoms: progressive exertional dyspnea, persistent nonproductive cough, hemoptysis, pleuritic chest pain
History of occupational exposure: asbestosis, silicosis
Abnormal chest imaging or pulmonary function tests
Take detailed history making sure to focus on past medical history (connective tissue disease, inflammatory bowel disease, malignancy), smoking history, family history, medications, occupational and environmental exposures
Physical exam is generally nonspecific

Work up and test results differ between types of interstitial lung diseases. Below are common studies obtained to determine disease. See page for specific disease for specific labs/imaging and findings.
CBC/CMP
Serologic studies: ANA, Rheumatoid factor
Imaging: Chest x-ray, chest CT
Pulmonary function tests
Cardiac ECHO
Bronchoalveolar lavage
Lung biopsy

Management differs between specific types of interstitial lung diseases. This is why it is important to determine specific cause of disease. See specific disease page for management.

Depending on how stable the patient is, patient can be admitted for work up or discharged for outpatient work up.
Important to determine acute vs chronic symptoms.

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