Important Restrictive Lung Diseases
Idiopathic Pulmonary Fibrosis
- It is the progressive fibrotic lung disease and It has not any defined etiology.
- It involves the chronic insult to the lung and there are multiple cycles of lung injury, inflammation and fibrosis.
- Its main association is with frequent exposure to ciggratte smoke or environmental pollution.
- The patient will present with progressive dyspnea, fatigue, crackles and clubbing.
- On Chest Xray: There will be honey comb appearance of the lung with peripheral reticular opacities.
- On Histology: It will present the Interstitial Pneumonia.
Also Read: Nephrogenic Systemic Fibrosis: Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention
Hypersensitivity Pneumonitis
- It is often seen in farmers and bird fanciers. It is a type of Hypersensitivity reaction to the environmental antigens.
- The findings will be dyspnea, cough, chest tightness, fever and headache.
- It is a self limiting disease but chronically it can lead to irreversible fibrosis with noncaseating granuloma, alveolar septal thickening and traction bronchiectasis.
Also Read: Chronic Pelvic Pain: Causes, Symptoms, Diagnosis and Treatment
Sarcoidosis
- It is an autoimmune disease which can affect multiple organs of the body and lungs are the most important parts to get affected.
- The main characteristic points are presence of widespread noncaseating granuloma, elevated serum ACE levels and elevated CD4/CD8 ratio in the Bronchoalveolar lavage.
- Very common in black females.
- Chest Xray will present as Bilateral adenopathy and coarse reticular opacities. CT chest is better.
- Other associated diseases are Bell’s palsy, Uveitis, hypercalcemia and erythema nodosum.
- Treatment is steroids
Pneumoconiosis
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Asbestosis- It is a type of pulmonary fibrosis caused due to exposure to asbestos.
- The other associated problems will be pleural disease and malignancies.
- The main reason for asbestos exposure is occupation at roofing , plumbing and shipbuilding.
- On Chest Xray, there will be presence of calcified, supradiaphragmatic and pleural plaques.
- It mainly affects the lower lobes and there is increased risk of bronchogenic carcinoma (more chances) and mesothelioma (less chances) .
- On visualizing the Asbestos bodies on BAL with prussian blue stain the golden-brown dumbbells like structures will be found .
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Berrylliosis
- It is associated with exposure to beryllium and it occurs in people who work in aerospace and manufacturing industries.
- Affects the upper lobes mainly.
- On histology, Non- Caseating granulomatous are seen.
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Coal workers pneumoconiosis
- Associated with prolonged exposure to the coal dust and that leads to black lung disease.
- Mainly affects the upper lobes
- Small, rounded nodular opacities seen on imaging.
- The dust particles get trapped in to the macrophages and then the further inflammation and fibrosis will occur.
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Silicosis
- It is associated with sandblasting, foundries and mines.
- Affects the upper lobes and on Chest xrays, egg-shell calcification of hilar lymoh nodes are found.
- The patients will have high susceptibility to TB. Macrophages respond to silica and release fibrogenic factors leading to fibrosis.
Radiation Induced Lung Injury
- It is associated with proinflammatory cytokine release ( TNF alpha, IL-1, IL-6) .
- Most common symptoms are dry cough and dyspnea.
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