A heterogenous group diffuse inflammatory

disorders that affect the alveoli and septal

interstitium of the lower respiratory tract of the
lung.

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,
ankylosing spondylitis

systemic

sclerosis

or

Dermatomyositis, polymyositis or mixed connective

tissue diseases

Occupational lung diseases

Inhalation of organic dusts extrinsic allergic alveolitis
: as Baggosis
Inhalation of inorganic dusts Pneumoconiosis : as
Asbestosis
Malignancy
Bronchoalveolar
carcinomatosis

carcinoma

and

lymphangitis

Leukaemias and lymphomas

Infectious diseases
Miliary tuberculosis, viral and atypical pneumonias

Medications
Methotrexate, Azathioprine and bleomycin
Sulphonamides, Aminodarone and insecticides
Miscellaneous
Ulcerative colitis, chronic active hepatitis
Alveolar proteinosis and microlithiasis
Hashimotos thyroiditis and Goodpastures syndrome

Pathological types
Mural types
Desquamative type
Lymphocytic type

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 allergic alveolitis
Symptoms
* Dry cough
* Gradual progressive dyspnea appearearly on exertion
but later at rest

Sign :
General signs
Clubbing
Cyanosis that appears early on exertion but later at rest
Local sign

Crackles

Rhonchi

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

reticulonodular infiltrates

distortion of the lung architecture and traction

bronchiectasis

 HRCT ( High Resolution CT scan )

Ventilation Perfusion scan
Blood test : leucocyte
Other tests : bronchoscopy, lung biopsy, etc.

Specific Treatment :
Steroid Prednisone
Other lines of treatment :
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