Interstitial lung disease


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Interstitial lung disease

  1. 1. A heterogenous group diffuse inflammatorydisorders that affect the alveoli and septalinterstitium of the lower respiratory tract ofthe lung.
  2. 2. Causes of interstitial lung diseases : Idiopathic pulmonary fibrosis • It is called cryptogenic fibrosing alveolitis or Hamman – rich syndrome • The cause is unknown but the disease represents the inflammatory and immune response of the lung to the tissue damage Collagenic vascular diseases • Rheumatoid arthritis, systemic sclerosis or ankylosing spondylitis • Dermatomyositis, polymyositis or mixed connective tissue diseases
  3. 3. Occupational lung diseases • Inhalation of organic dusts “extrinsic allergic alveolitis” : as Baggosis • Inhalation of inorganic dusts “ Pneumoconiosis” : as Asbestosis Malignancy • Bronchoalveolar carcinoma and lymphangitis carcinomatosis • Leukaemias and lymphomas Infectious diseases• Miliary tuberculosis, viral and atypical pneumonias
  4. 4. Medications• Methotrexate, Azathioprine and bleomycin• Sulphonamides, Aminodarone and insecticidesMiscellaneous• Ulcerative colitis, chronic active hepatitis• Alveolar proteinosis and microlithiasis• Hashimoto’s thyroiditis and Goodpasture’s syndrome
  5. 5. Pathological types• Mural types• Desquamative type• Lymphocytic type
  6. 6. Symptoms : Onset* It usually insidious and gradually progressive* It may be acute with rapidly progressive course“in Hamman rich syndrome”* It may be subacute “in extrinsic allergicalveolitis” Symptoms* Dry cough* Gradual progressive dyspnea appearearly on
  7. 7. Sign : General signs • Clubbing • Cyanosis that appears early on exertion but later at rest Local sign• Crackles• Rhonchi
  8. 8. Radiological investigations : Chest x-ray• Diffuse bilateral reticulonodular pattern through both lung fields• It is more pronounced at the lower lung zone• Honey comb appearance• Homogenous opacity• Multiple shadows of equal size scattered all over lung in milliary TB• Features of complications : Right ventricular enlargement , Pulmonary hypertension
  9. 9. reticulonodular infiltrates
  10. 10. distortion of the lung architecture and traction bronchiectasis
  11. 11.  HRCT ( High Resolution CT scan ) Ventilation – Perfusion scanBlood test : leucocyteOther tests : bronchoscopy, lung biopsy, etc.
  12. 12. Specific Treatment : Steroid “Prednisone”Other lines of treatment : Symptomatic treatment as : oxygen inhalation andantitussive • Supportive treatment as : good nutrition and vitamins • Treatment of the cause : as pulmonary infections • Treatment of complications as
  13. 13. Symptomatic treatment as : oxygen inhalation and antitussive• Supportive treatment as : good nutrition and vitamins• Treatment of the cause : as pulmonary infections• Treatment of complications as - Pulmonary hypertension and corpulmonale