Interstitial lung disease

Causes

Appropriate 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 gas arterial if indicated.

See also Occupational lung disease

Inhalation of environmental agents

 

Inorganic dusts (pneumoconiosis), especially

  • Asbestosis
  • Silicosis

 

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

  • Churg-Strauss disease
  • Granulomatosis with polyangiitis

Full blood count, White cell count differential, Blood film; Erythrocyte sedimentation rate; Immunoglobulins G, A, M; Antineutrophil cytoplasmic Ab.

Other

 

Histiocytosis X

 

Connective tissue diseases

 

Pulmonary irradiation

 

Idiopathic pulmonary fibrosis (cryptogenic fibrosing alveolitis)