Interstitial lung disease

Last updated: Tuesday, 14, December, 2010
CausesAppropriate Tests

Review clinical features, particularly environmental and occupational history, for evidence of inhalation of dusts or fumes.

Bronchoalveolar lavage with cytology and differential cell count may be useful for diagnosis and follow up.

Lung biopsy if diagnosis uncertain; open lung biopsy may be indicated for some forms of diffuse disease.

Blood gases if indicated.

See also Occupational lung disease

Inhalation of environmental agents

Inorganic dusts (pneumoconiosis), especially

Organic dusts (extrinsic allergic alveolitis)

  • Farmer's lung
  • Bird fancier's lung
Precipitins

Gases, fumes, vapours, especially

  • Welder's lung

Drug reactions

Cytotoxic drugs, especially

  • Methotrexate
  • Bleomycin
  • Busulphan

Other, including

  • Amiodarone
  • Nitrofurantoin
  • Sulphonamides
  • Penicillins

Granulomatous lung disease

Mycobacterial infection

Sarcoidosis

Vasculitis associated, especially

FBC, differential WCC, blood film; ESR; immunoglobulins G, A, M; antineutrophil cytoplasmic antibodies.
Other

Histiocytosis X

Connective tissue diseases

Pulmonary irradiation

Idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis)