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| __NOTOC__ | | __NOTOC__ |
| {{Malabsorption}}
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| {{CMG}}; {{AE}} {{SSH}}
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| ==Overview==
| | [[Sandbox: wdx]] |
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| ==Classification==
| | [[Xyz]] |
| ==Pathophysiology==
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| * Interstitial lung disease is a group of disorders that involve pulmonary parenchyma.
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| * The exact pathogenesis of these disorders are not fully understood.
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| * There are multiple initiating factors that cause pulmonary injury. However, immunopathogenic responses of lung tissue are quite similar.
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| * There are two major histopathologic patterns in response to lung injury which include:
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| ** Inflammation and fibrosis pattern
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| ** Granulomatous pattern
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| | |
| ==Differentiating Interstitial Lung Disease from other Diseases==
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| '''''To review the complete differential diagnosis of dyspnea, click here.'''''
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| '''''To review the complete differential diagnosis of hemoptysis, click here.'''''
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| '''''To review the complete differential diagnosis of restrictive lung disease, click here.'''''
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| '''Abbreviations''': '''ABG''': Arterial blood gas, '''BAL''': Bronchoalveolar lavage, '''ESR''': Erythrocyte sedimentation rate, '''CRP''': C–reactive protein, '''FVC''': Forced vital capacity, '''RV''': Residual volume, '''FEV1''': Forced expiratory volume during the 1st second, '''DLCO''': Diffusing capacity of the lungs for carbon monoxide, '''O2''': Oxygen, '''TLC''': Total lung capacity, '''PaO2''': Arterial partial pressure of oxygen, '''FiO2''': Fraction of inspired oxygen, '''LDH''': Lactate dehydrogenase, '''CEA''': Carcinoembryonic antigen, '''Anti-GBM antibody''': Anti-glomerular basement membrane antibody, '''A−a gradient''': Alveolar-arterial gradient, '''PAS''': Periodic acid-Schiff stain, '''LAM''': Lymphangiomyomatosis, '''IgE''': Immunoglobulin E, '''ANCA''': Anti-neutrophil cytoplasmic antibody, '''RBC''': Red blood cell, '''ACE''': Angiotensin-converting enzyme
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| <small><small>
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|
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|
| | [[Abc]] |
| | # [[Sandbox:Preeti]] |
| | # [[Lymphoma]] |
| | # [[Breast lumps differential diagnosis]] |
| | # [[Neck masses differential diagnosis]] |
| | # [[Leukemia]] |
| {| class="wikitable" | | {| class="wikitable" |
| ! colspan="2" rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | |+ |
| ! colspan="15" style="background:#4479BA; color: #FFFFFF;" align="center" |Clinical manifestation
| |
| ! colspan="6" style="background:#4479BA; color: #FFFFFF;" align="center" |Investigations
| |
| |- | | |- |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |History
| | | colspan="2" |[[:Category:Risk calculator]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
| | [[Category:Risk calculator]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Physical examination
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab findings
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Pulmonary function test
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Bronchoscopy and BAL
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| | | colspan="2" |[[Deep vein thrombosis assessment of clinical probability and risk scores]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Age
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Gender
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Family history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Smoking history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Environmental exposure
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |HIV
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cough
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Wheezing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Tachypnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Spirometry
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Idiopathic pulmonary fibrosis<ref name="PolettiRavaglia2013">{{cite journal|last1=Poletti|first1=Venerino|last2=Ravaglia|first2=Claudia|last3=Buccioli|first3=Matteo|last4=Tantalocco|first4=Paola|last5=Piciucchi|first5=Sara|last6=Dubini|first6=Alessandra|last7=Carloni|first7=Angelo|last8=Chilosi|first8=Marco|last9=Tomassetti|first9=Sara|title=Idiopathic Pulmonary Fibrosis: Diagnosis and Prognostic Evaluation|journal=Respiration|volume=86|issue=1|year=2013|pages=5–12|issn=1423-0356|doi=10.1159/000353580}}</ref>
| | | colspan="2" |[[Pulmonary embolism assessment of clinical probability and risk scores]] |
| | align="center" |Chronic
| | |- |
| | align="center" |60−70 years old
| | |[[Padua prediction score]] |
| | align="center" |Men
| | |[[widget:PaduaVTEscore]] |
| | align="center" | +
| | |- |
| | align="center" | +
| | |[[IMPROVE risk score calculator]] |
| | align="center" |±
| | |[[Widget:IMPROVEScore]] |
| | align="center" | −
| | |- |
| | align="center" | +
| | |[[IMPROVEDD risk score calculator]] |
| | align="center" |Dry | | |[[Widget:IMPROVEDDScore]] |
| | align="center" | +
| | |- |
| | align="center" | +
| | |[[Caprini score calculator]] |
| | align="center" | +
| | |[[Widget:CapCal]] |
| |
| | |- |
| * Inspiratory high−pitched [[rhonchi]]
| | |[[Wells score calculator for DVT]] |
| * Bibasilar inspiratory [[Rales|crackles]]
| | |[[Widget:DVT Wells score calculator]] |
| | align="center" | − | | |- |
| | align="center" | +
| | |[[Modified Wells score calculator for DVT]] |
| | | | |[[Widget:DVT Modified Wells score calculator]] |
| * [[Anti-nuclear antibody|Antinuclear antibody]] +
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| * [[Rheumatoid factor]] +
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| * Elevated [[Erythrocyte sedimentation rate|ESR]]
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| * Elevated [[C-reactive protein|CRP]]
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| * [[Polycythemia]]
| |
| | | |
| * Bibasilar, peripheral reticular abnormalities
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| * Focal honeycomb cyst formation
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| * Traction [[bronchiectasis]]
| |
| | | |
| * ↓ [[Vital capacity|FVC]]
| |
| | |
| * ↑ [[Residual volume|RV]]
| |
| * Normal [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↓ [[DLCO]]
| |
| | | |
| * ↓ [[Oxygen|O2]]
| |
| | | |
| * Not required
| |
| * ↑ [[Neutrophil|Neutrophils]]
| |
| * ↑ [[Eosinophil granulocyte|Eosinophils]]
| |
| | | |
| * Diagnosis of exclusion
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" s |Idiopathic nonspecific interstitial pneumonia<ref name="TravisHunninghake2008">{{cite journal|last1=Travis|first1=William D.|last2=Hunninghake|first2=Gary|last3=King|first3=Talmadge E.|last4=Lynch|first4=David A.|last5=Colby|first5=Thomas V.|last6=Galvin|first6=Jeffrey R.|last7=Brown|first7=Kevin K.|last8=Chung|first8=Man Pyo|last9=Cordier|first9=Jean-François|last10=du Bois|first10=Roland M.|last11=Flaherty|first11=Kevin R.|last12=Franks|first12=Teri J.|last13=Hansell|first13=David M.|last14=Hartman|first14=Thomas E.|last15=Kazerooni|first15=Ella A.|last16=Kim|first16=Dong Soon|last17=Kitaichi|first17=Masanori|last18=Koyama|first18=Takashi|last19=Martinez|first19=Fernando J.|last20=Nagai|first20=Sonoko|last21=Midthun|first21=David E.|last22=Müller|first22=Nestor L.|last23=Nicholson|first23=Andrew G.|last24=Raghu|first24=Ganesh|last25=Selman|first25=Moisés|last26=Wells|first26=Athol|title=Idiopathic Nonspecific Interstitial Pneumonia|journal=American Journal of Respiratory and Critical Care Medicine|volume=177|issue=12|year=2008|pages=1338–1347|issn=1073-449X|doi=10.1164/rccm.200611-1685OC}}</ref>
| | |[[Pulmonary embolism Wells score calculator]] |
| | align="center" |Acute/Chronic
| | |[[widget:PE_calculator]] |
| | align="center" |50−60 years old
| |
| | align="center" |Female
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" | −
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | | |
| * Bibasilar [[Rales|crackles]]
| |
| | align="center" | − | |
| | align="center" |±
| |
| |
| |
| * Normal
| |
| |
| |
| * Bilateral ground−glass opacities
| |
| * Fine reticular infiltrates
| |
| * Traction [[bronchiectasis]]
| |
| * [[Consolidation (medicine)|Consolidation]]
| |
| |
| |
| * Normal to ↑ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↓ [[Vital capacity|FVC]]
| |
| * ↓ [[Total lung capacity|TLC]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * Nonspecific
| |
| |
| |
| * Lung [[biopsy]] and multidisciplinary approach
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Cryptogenic organising pneumonia<ref name="MehrianDoroudinia2017">{{cite journal|last1=Mehrian|first1=P.|last2=Doroudinia|first2=A.|last3=Rashti|first3=A.|last4=Aloosh|first4=O.|last5=Dorudinia|first5=A.|title=High-resolution computed tomography findings in chronic eosinophilic vs. cryptogenic organising pneumonia|journal=The International Journal of Tuberculosis and Lung Disease|volume=21|issue=11|year=2017|pages=1181–1186|issn=1027-3719|doi=10.5588/ijtld.16.0723}}</ref>
| | |[[Pulmonary embolism modified Wells score calculator]] |
| | align="center" |Acute/subacute
| | |[[Widget:PE Modified Wells score calculator]] |
| | align="center" |50−60 years old
| |
| | align="center" |Both
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |Dry
| |
| | align="center" | −
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | | |
| * Inspiratory [[Rales|crackles]]
| |
| | align="center" | − | |
| | align="center" |−
| |
| |
| |
| * [[Leukocytosis]]
| |
| | |
| * Elevated [[Erythrocyte sedimentation rate|ESR]]
| |
| * Elevated [[C-reactive protein|CRP]]
| |
| |
| |
| * [[Alveolus|Alveolar]] filling and air bronchograms
| |
| * Bilateral ground−glass opacities
| |
| * Bilateral [[Consolidation (medicine)|consolidation]]
| |
| |
| |
| * ↓ [[Vital capacity|FVC]]
| |
| | |
| * Normal [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * ↑ [[Lymphocyte|Lymphocytes]]
| |
| | |
| * ↑ [[Neutrophil|Neutrophils]]
| |
| * ↑ [[Eosinophil granulocyte|Eosinophils]]
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | |[[AMUSE score calculator]] |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |History
| | |[[Widget:AMUSE_score_calculator]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
| |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Physical examination
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab findings
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Pulmonary function test
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Bronchoscopy and BAL
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| | |[[HAMILTON score calculator]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Age
| | |[[Widget:HAMILTON_score_calculator]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Gender
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Family history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Smoking history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Environmental exposure
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |HIV
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cough
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Wheezing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Tachypnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Spirometry
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Acute interstitial pneumonia (Hamman−Rich syndrome)<ref name="ParambilMukhopadhyay2012">{{cite journal|last1=Parambil|first1=Joseph|last2=Mukhopadhyay|first2=Sanjay|title=Acute Interstitial Pneumonia (AIP): Relationship to Hamman-Rich Syndrome, Diffuse Alveolar Damage (DAD), and Acute Respiratory Distress Syndrome (ARDS)|journal=Seminars in Respiratory and Critical Care Medicine|volume=33|issue=05|year=2012|pages=476–485|issn=1069-3424|doi=10.1055/s-0032-1325158}}</ref>
| | |[[Geneva score calculator]] |
| | align="center" |Acute
| | |[[Widget:Geneva_score_calculator]] |
| | align="center" |50−60 years old
| |
| | align="center" |Both
| |
| | align="center" | −
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |− | |
| | align="center" | +
| |
| |
| |
| * Diffuse [[Rales|crackles]]
| |
| | align="center" | − | |
| | align="center" | −
| |
| |
| |
| * [[Leukocytosis]]
| |
| |
| |
| * Bilateral and symmetric, diffuse ground glass
| |
| * [[Alveolus|Alveolar]] consolidation opacities
| |
| * Traction [[bronchiectasis]]
| |
| * Honeycomb [[fibrosis]]
| |
| |
| |
| * N/A
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| * [[Pulmonary gas pressures|PaO2]]/[[FiO2]] <200 mmHg
| |
| |
| |
| * Nonspecific
| |
| * ↑ [[Neutrophil|Neutrophils]]
| |
| * ↑ Atypical [[Epithelium|epithelial cells]]
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Lymphocytic interstitial pneumonia<ref name="PanchabhaiFarver2016">{{cite journal|last1=Panchabhai|first1=Tanmay S.|last2=Farver|first2=Carol|last3=Highland|first3=Kristin B.|title=Lymphocytic Interstitial Pneumonia|journal=Clinics in Chest Medicine|volume=37|issue=3|year=2016|pages=463–474|issn=02725231|doi=10.1016/j.ccm.2016.04.009}}</ref>
| | |[[Revised Geneva score calculator]] |
| | align="center" |Subacute
| | |[[Widget:Revised_Geneva_score_calculator]] |
| | align="center" |30−40 years old
| |
| | align="center" |Female
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | | |
| * Diffuse [[Rales|crackles]]
| |
| | align="center" | − | |
| | align="center" | +
| |
| |
| |
| * [[Gammopathy]]
| |
| |
| |
| * Diffuse ground glass attenuation with [[fibrosis]]
| |
| * Centrilobular and subpleural [[Nodule (medicine)|nodules]]
| |
| * Lung [[Cyst|cysts]]
| |
| |
| |
| * ↓ [[Vital capacity|FVC]]
| |
| * ↓ [[Total lung capacity|TLC]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * Nonspecific
| |
| * ↑ Total [[Bronchoalveolar lavage|BAL]] cell count
| |
| * [[Bronchoalveolar lavage|BAL]] [[lymphocytosis]]
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Respiratory bronchiolitis−interstitial lung disease<ref name="SieminskaKuziemski2014">{{cite journal|last1=Sieminska|first1=Alicja|last2=Kuziemski|first2=Krzysztof|title=Respiratory bronchiolitis-interstitial lung disease|journal=Orphanet Journal of Rare Diseases|volume=9|issue=1|year=2014|issn=1750-1172|doi=10.1186/s13023-014-0106-8}}</ref>
| | |[[Simplified Geneva Score calculator]] |
| | align="center" |Subacute
| | |[[Widget:Simplified_Geneva_score_calculator]] |
| | align="center" |30−40 years old
| |
| | align="center" |Both
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" | −
| |
| | align="center" | +
| |
| | align="center" |Dry
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | align="center" | −
| |
| |
| |
| * Inspiratory high−pitched [[rhonchi]]
| |
| * Fine, bibasilar end−inspiratory [[Rales|crackles]]
| |
| | align="center" |−
| |
| | align="center" |−
| |
| |
| |
| * Nonspecific
| |
| |
| |
| * Diffuse or patchy ground glass opacities in a mosaic pattern
| |
| * Fine [[Nodule (medicine)|nodules]]
| |
| * Air trapping
| |
| |
| |
| * ↓ [[Vital capacity|FVC]]
| |
| * ↓ [[Total lung capacity|TLC]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * ↑ [[Macrophage|Macrophages]]
| |
| |
| |
| * Clinical evaluation and investigations
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Desquamative interstitial pneumonia<ref name="RyuMyers2005">{{cite journal|last1=Ryu|first1=Jay H.|last2=Myers|first2=Jeffrey L.|last3=Capizzi|first3=Stephen A.|last4=Douglas|first4=William W.|last5=Vassallo|first5=Robert|last6=Decker|first6=Paul A.|title=Desquamative Interstitial Pneumonia and Respiratory Bronchiolitis-Associated Interstitial Lung Disease|journal=Chest|volume=127|issue=1|year=2005|pages=178–184|issn=00123692|doi=10.1378/chest.127.1.178}}</ref><ref name="CraigWells2004">{{cite journal|last1=Craig|first1=P J|last2=Wells|first2=A U|last3=Doffman|first3=S|last4=Rassl|first4=D|last5=Colby|first5=T V|last6=Hansell|first6=D M|last7=du Bois|first7=R M|last8=Nicholson|first8=A G|title=Desquamative interstitial pneumonia, respiratory bronchiolitis and their relationship to smoking|journal=Histopathology|volume=45|issue=3|year=2004|pages=275–282|issn=0309-0167|doi=10.1111/j.1365-2559.2004.01921.x}}</ref>
| | |[[TIMI Risk Score for Unstable Angina or NSTEMI]] |
| | align="center" |Chronic
| | |[[Widget:TIMI_UA_NSTEMI]] |
| | align="center" |40−50 years old
| |
| | align="center" |Both
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |Dry
| |
| | align="center" | +
| |
| | align="center" |− | |
| | align="center" |−
| |
| |
| |
| * Fine, bibasilar end−inspiratory [[Rales|crackles]]
| |
| | align="center" |− | |
| | align="center" |−
| |
| |
| |
| * Nonspecific
| |
| |
| |
| * Ground glass opacities without the peripheral reticular and reticulonodular opacities
| |
| |
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * ↑ [[Eosinophil granulocyte|Eosinophils]]
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | |[[TIMI Risk Score for STEMI]] |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |History
| | |[[Widget:TIMI_STEMI]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
| |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Physical examination
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab findings
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Pulmonary function test
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Bronchoscopy and BAL
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| | |[[Tygerberg score]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Age
| | |[[widget:Tygerberg_score]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Gender
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Family history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Smoking history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Environmental exposure
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |HIV
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cough
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Wheezing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Tachypnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Spirometry
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Pulmonary Langerhans cell granulomatosis<ref name="BlakleyDutcher2018">{{cite journal|last1=Blakley|first1=Matthew P.|last2=Dutcher|first2=Janice P.|last3=Wiernik|first3=Peter H.|title=Pulmonary Langerhans cell histiocytosis, acute myeloid leukemia, and myelofibrosis in a large family and review of the literature|journal=Leukemia Research|volume=67|year=2018|pages=39–44|issn=01452126|doi=10.1016/j.leukres.2018.01.011}}</ref>
| | |[[CHA2DS2-VASc Score]] |
| | align="center" |Chronic | | |[[Widget:CHA2DS2VASc]] |
| | align="center" |20−40 years old
| |
| | align="center" |Both
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" |Dry
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| |
| |
| * Unremarkable
| |
| |−
| |
| |−
| |
| |
| |
| * Nonspecific
| |
| |
| |
| * Mid to upper lung zone [[Cyst|cysts]] and [[Nodule (medicine)|nodules]]
| |
| * Reticular and [[Nodule (medicine)|nodular]] opacities
| |
| * Recurrent spontaneous [[pneumothorax]]
| |
| |
| |
| * ↓ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * Normal
| |
| |
| |
| * >5 percent [[Langerhans cell|langerhans cells]] (CD−1a positive)
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Pulmonary alveolar proteinosis<ref name="pmid29493933">{{cite journal |vauthors=Carrington JM, Hershberger DM |title= |journal= |volume= |issue= |pages= |date= |pmid=29493933 |doi= |url=}}</ref><ref name="KianiParsa2018">{{cite journal|last1=Kiani|first1=Arda|last2=Parsa|first2=Tahereh|last3=Adimi Naghan|first3=Parisa|last4=Dutau|first4=Hervé|last5=Razavi|first5=Fatemeh|last6=Farzanegan|first6=Behrooz|last7=Pourabdollah Tootkaboni|first7=Mahsa|last8=Abedini|first8=Atefeh|title=An eleven-year retrospective cross-sectional study on pulmonary alveolar proteinosis|journal=Advances in Respiratory Medicine|volume=86|issue=1|year=2018|pages=7–12|issn=2543-6031|doi=10.5603/ARM.2018.0003}}</ref>
| | |[[CHADS2 score]] |
| | align="center" |Acute/chronic
| | |[[Widget:CHADS2score]] |
| | align="center" |40−50 years old
| |
| | align="center" |Male
| |
| | align="center" | + | |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |−
| |
| |
| |
| * Inspiratory [[Rales|crackles]]
| |
| | align="center" | + | |
| | align="center" | +
| |
| |
| |
| * ↑ [[Lactate dehydrogenase|LDH]]
| |
| * ↑ [[CEA]]
| |
| * ↑ [[Surfactant]] protein A, B, and D
| |
| * [[Anti-glomerular basement membrane antibody|Anti-GBM antibody]] +
| |
| * [[Polycythemia]]
| |
| * [[Hypergammaglobulinemia]]
| |
| |
| |
| * Bbilateral perihilar and basilar [[Alveolus|alveolar]] opacities without air−bronchograms
| |
| * "Bat wing" distribution
| |
| * Intralobular thickening
| |
| * Diffuse ground−glass opacities
| |
| |
| |
| * ↑ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↑ [[A-a gradient|A−a gradient]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Pulmonary gas pressures|PaO2]]
| |
| * ↓ [[Oxygen|O2]]
| |
| * [[Respiratory alkalosis]]
| |
| |
| |
| * Large foamy [[Macrophage|macrophages]] with amorphous [[Periodic acid-Schiff stain|PAS]]−positive material
| |
| * ↑ [[Lymphocyte|Lymphocytes]]
| |
| |
| |
| * [[Bronchoscopy]] and [[Bronchoalveolar lavage|BAL]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Pulmonary lymphangioleiomyomatosis<ref name="XuLo2014">{{cite journal|last1=Xu|first1=Kai-Feng|last2=Lo|first2=Bee Hong|title=Lymphangioleiomyomatosis: differential diagnosis and optimal management|journal=Therapeutics and Clinical Risk Management|year=2014|pages=691|issn=1178-203X|doi=10.2147/TCRM.S50784}}</ref>
| | |[[HAS-BLED score]] |
| | align="center" |Acute/chronic
| | |[[Widget:HASBLEDscore]] |
| | align="center" |30−40 years old
| |
| | align="center" |Female | |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |Bloody
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| |
| |
| * Decreased [[breath sounds]]
| |
| | align="center" |− | |
| | align="center" | +
| |
| |
| |
| * ↑ [[Vascular endothelial growth factor|Vascular endothelial growth factor−D]] (VEGF−D)
| |
| |
| |
| * [[Pneumothorax]]
| |
| * [[Chylothorax]]
| |
| * Thin−walled round [[Cyst|cystic]] lesions
| |
| |
| |
| * ↓ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * ↓ [[Pulmonary gas pressures|PaO2]]
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * [[LAM]] cells +
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Eosinophilic pneumonia<ref name="BernheimMcLoud2017">{{cite journal|last1=Bernheim|first1=Adam|last2=McLoud|first2=Theresa|title=A Review of Clinical and Imaging Findings in Eosinophilic Lung Diseases|journal=American Journal of Roentgenology|volume=208|issue=5|year=2017|pages=1002–1010|issn=0361-803X|doi=10.2214/AJR.16.17315}}</ref>
| | |[[The GRACE risk score]] |
| | align="center" |Acute/chronic
| | |[[Widget:GRACEscore]] |
| | align="center" |20−40 years old
| |
| | align="center" |Male
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |Dry
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| |
| |
| * Decreased [[breath sounds]]
| |
| | align="center" |− | |
| | align="center" |−
| |
| |
| |
| * Neutrophilic [[leukocytosis]]
| |
| * ↑ [[Eosinophil granulocyte|Eosinophils]]
| |
| * Elevated [[Erythrocyte sedimentation rate|ESR]]
| |
| * Elevated [[C-reactive protein|CRP]]
| |
| * Elevated [[Immunoglobulin E|IgE]] level
| |
| |
| |
| * Bilateral diffuse mixed ground glass and reticular opacities
| |
| * Small bilateral [[Pleural effusion|pleural effusions]]
| |
| * Centrilobular [[Nodule (medicine)|nodules]] and air−space [[Consolidation (medicine)|consolidation]]
| |
| |
| |
| * ↑ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Pulmonary gas pressures|PaO2]]
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * [[Eosinophilia]]
| |
| |
| |
| * Clinical evaluation and investigations
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Hypersensitivity pneumonitis<ref name="MillerAllen2018">{{cite journal|last1=Miller|first1=Ross|last2=Allen|first2=Timothy Craig|last3=Barrios|first3=Roberto J.|last4=Beasley|first4=Mary Beth|last5=Burke|first5=Louise|last6=Cagle|first6=Philip T.|last7=Capelozzi|first7=Vera Luiza|last8=Ge|first8=Yimin|last9=Hariri|first9=Lida P.|last10=Kerr|first10=Keith M.|last11=Khoor|first11=Andras|last12=Larsen|first12=Brandon T.|last13=Mark|first13=Eugene J.|last14=Matsubara|first14=Osamu|last15=Mehrad|first15=Mitra|last16=Mino-Kenudson|first16=Mari|last17=Raparia|first17=Kirtee|last18=Roden|first18=Anja Christiane|last19=Russell|first19=Prudence|last20=Schneider|first20=Frank|last21=Sholl|first21=Lynette M.|last22=Smith|first22=Maxwell Lawrence|title=Hypersensitivity Pneumonitis A Perspective From Members of the Pulmonary Pathology Society|journal=Archives of Pathology & Laboratory Medicine|volume=142|issue=1|year=2018|pages=120–126|issn=0003-9985|doi=10.5858/arpa.2017-0138-SA}}</ref>
| |
| | align="center" |Acute/subacute/chronic
| |
| | align="center" |40−60 years old
| |
| | align="center" |Both
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | align="center" | +
| |
| | align="center" |Dry/productive
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| |
| |
| * Diffuse fine bibasilar [[crackles]]
| |
| | align="center" | −
| |
| | align="center" | +
| |
| |
| |
| * Neutrophilic [[leukocytosis]]
| |
| |
| |
| * Centrilobular ground−glass or nodular opacities of mid−to−upper zone
| |
| * Air−trapping
| |
| | | | | |
| * ↓ [[FEV1]]
| |
| * ↓ [[Vital capacity|FVC]]
| |
| | | | | |
| * ↓ [[Pulmonary gas pressures|PaO2]]
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * [[Lymphocytosis]]
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | |[[Ranson criteria]] |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |History
| | [[Acute pancreatitis diagnostic criteria]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
| | |[[Widget:RansonScore]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Physical examination
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab findings
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Pulmonary function test
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Bronchoscopy and BAL
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| | |[[Apgar score]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Age
| | |[[Widget:Apgarscore]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Gender
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Family history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Smoking history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Environmental exposure
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |HIV
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cough
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Wheezing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Tachypnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Spirometry
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Occupational lung disease<ref name="SirajuddinKanne2009">{{cite journal|last1=Sirajuddin|first1=Arlene|last2=Kanne|first2=Jeffrey P.|title=Occupational Lung Disease|journal=Journal of Thoracic Imaging|volume=24|issue=4|year=2009|pages=310–320|issn=0883-5993|doi=10.1097/RTI.0b013e3181c1a9b3}}</ref>
| | |[[Glasgow coma scale]] |
| | align="center" |Chronic
| | |[[Widget:Adult_GCS]] |
| | align="center" |Elderly
| |
| | align="center" |Male
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| |
| |
| * Fine [[Rales|crackles]]
| |
| | align="center" |Peripheral/central | |
| | align="center" | +
| |
| |
| |
| * [[Anemia]]
| |
| * [[Neutrophilia]]
| |
| * Elevated [[Erythrocyte sedimentation rate|ESR]]
| |
| * Elevated [[C-reactive protein|CRP]]
| |
| * Elevated [[Antibody|immunoglobulin]]
| |
| |
| |
| * Pleural thickening and [[Plaque|plaques]]
| |
| * [[Calcification]]
| |
| * Nodular or reticular opacities
| |
| * Lobar consolidation
| |
| * [[Atelectasis]]
| |
| * Parenchymal bands
| |
| * Enlarged hilar or mediastinal [[Lymph node|lymph nodes]]
| |
| * Granulomata
| |
| |
| |
| * ↑ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| * ↑ CO2
| |
| * [[Respiratory acidosis]]
| |
| |
| |
| * Mineral dust +
| |
| |
| |
| * History of environmental exposure and imaging
| |
| * Lung [[biopsy]] not required
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Radiation−induced lung injury<ref name="pmid25854336">{{cite journal |vauthors=Giridhar P, Mallick S, Rath GK, Julka PK |title=Radiation induced lung injury: prediction, assessment and management |journal=Asian Pac. J. Cancer Prev. |volume=16 |issue=7 |pages=2613–7 |date=2015 |pmid=25854336 |doi= |url=}}</ref>
| | |[[Pediatric Glasgow Coma Scale]] |
| | align="center" |Subacute/chronic
| | |[[Widget:PGCS]] |
| | align="center" |Any age
| |
| | align="center" |Both
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |Dry
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| |
| |
| * [[Rales|Crackles]]
| |
| * [[Pleural friction rub|Pleural rub]]
| |
| * Dullness to [[percussion]]
| |
| | align="center" | +
| |
| | align="center" |−
| |
| |
| |
| * Nonspecific
| |
| |
| |
| * Perivascular haziness to patchy [[Alveolus|alveolar]] filling densities
| |
| * Straight line effect
| |
| * [[Pleural effusion]]
| |
| |
| |
| * ↓ [[Total lung capacity|TLC]]
| |
| * ↓ [[Vital capacity|FVC]]
| |
| * ↓ [[Spirometry|FEV1]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Pulmonary gas pressures|PaO2]]
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * [[Lymphocytosis]]
| |
| |
| |
| * History of irradiation and clinical presentation
| |
| |- | | |- |
| ! rowspan="3" style="background:#DCDCDC;" align="center" |Pulmonary hemorrhage syndromes
| | |[[Cincinnati stroke scale]] |
| ! style="background:#DCDCDC;" align="center" |Goodpasture syndrome<ref name="pmid29083697">{{cite journal |vauthors=DeVrieze BW, Hurley JA |title= |journal= |volume= |issue= |pages= |date= |pmid=29083697 |doi= |url=}}</ref>
| | |[[Widget:Cincinnati_Stroke_Scale]] |
| | align="center" |Chronic
| |
| | align="center" |All ages
| |
| | align="center" |Male
| |
| | align="center" | +
| |
| | align="center" |±
| |
| | align="center" | −
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" |Bloody
| |
| | align="center" |±
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | | |
| * Bilateral coarse [[crepitations]]
| |
| | align="center" |− | |
| | align="center" |−
| |
| |
| |
| * [[Anti-glomerular basement membrane antibody|Anti-GBM antibody]] +
| |
| * [[Anti-neutrophil cytoplasmic antibody|ANCA]] +
| |
| * [[Anemia]]
| |
| * [[Red blood cell|RBC]] in the urine
| |
| |
| |
| * Pulmonary infiltrates
| |
| |
| |
| * ↑ [[DLCO]]
| |
| |
| |
| * Normal
| |
| |
| |
| * NA
| |
| |
| |
| * Kidney [[biopsy]]
| |
| |- | | |- |
| ! style="background:#DCDCDC;" align="center" |Idiopathic pulmonary hemosiderosis<ref name="KhorashadiWu2015">{{cite journal|last1=Khorashadi|first1=L.|last2=Wu|first2=C.C.|last3=Betancourt|first3=S.L.|last4=Carter|first4=B.W.|title=Idiopathic pulmonary haemosiderosis: spectrum of thoracic imaging findings in the adult patient|journal=Clinical Radiology|volume=70|issue=5|year=2015|pages=459–465|issn=00099260|doi=10.1016/j.crad.2014.11.007}}</ref>
| | |[[DIPSS Plus Score]] |
| | align="center" |Acute/subacute/chronic
| | |[[Widget:DIPSS_Plus_Score]] |
| | align="center" |Children − 10 years old
| |
| | align="center" |Both
| |
| | align="center" | +
| |
| | align="center" |±
| |
| | align="center" | −
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" |Bloody
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | | |
| * [[Rales|Crackles]]
| |
| | align="center" | − | |
| | align="center" |−
| |
| |
| |
| * [[Iron deficiency anemia]]
| |
| * ↑ Plasma [[bilirubin]]
| |
| * ↑ Urinary excretion of [[urobilinogen]]
| |
| * ↑ [[Reticulocytes]]
| |
| * [[Fecal occult blood]] +
| |
| |
| |
| * Mid to lower zone [[Alveolus|alveolar]] opacities
| |
| * Multiple honeycomb [[Cyst|cysts]]
| |
| |
| |
| * ↓ [[Lung volumes|TLC]]
| |
| * ↓ [[Vital capacity|FVC]]
| |
| * ↓ [[Spirometry|FEV1]]
| |
| * ↑ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↑ [[DLCO]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| * ↓ CO2
| |
| |
| |
| * ↑ [[Hemosiderin]]−laden [[Macrophage|macrophages]]
| |
| |
| |
| * Clinical evaluation and investigations
| |
| |- | | |- |
| ! style="background:#DCDCDC;" align="center" |Isolated pulmonary capillaritis<ref name="ThompsonKlecka2016">{{cite journal|last1=Thompson|first1=Gwen|last2=Klecka|first2=Mary|last3=Roden|first3=Anja C.|last4=Specks|first4=Ulrich|last5=Cartin-Ceba|first5=Rodrigo|title=Biopsy-proven pulmonary capillaritis: A retrospective study of aetiologies including an in-depth look at isolated pulmonary capillaritis|journal=Respirology|volume=21|issue=4|year=2016|pages=734–738|issn=13237799|doi=10.1111/resp.12738}}</ref>
| | | colspan="2" |[[ICU scoring systems]] |
| | align="center" |Chronic
| |
| | align="center" |40−60 years old
| |
| | align="center" |Both
| |
| | align="center" | +
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" | −
| |
| | align="center" | +
| |
| | align="center" |Bloody
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| |
| |
| * Decreased [[breath sounds]]
| |
| | align="center" |−
| |
| | align="center" |−
| |
| |
| |
| * [[Anemia]]
| |
| * [[Leukocytosis]]
| |
| |
| |
| * Diffuse [[Alveolus|alveolar]] haemorrhage
| |
| |
| |
| * ↓ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * Diffuse [[Alveolus|alveolar]] haemorrhage
| |
| |
| |
| * Diagnosis of exclusion
| |
| |- | | |- |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| | |[[APACHE II]] |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |History
| | |[[Widget:APACHEII]] |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
| |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Physical examination
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab findings
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Pulmonary function test
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Bronchoscopy and BAL
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Duration
| | |[[SAPS II]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Age
| | |[[Widget:SAPSII]] |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Gender
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Family history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Smoking history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Environmental exposure
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |HIV
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cough
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Wheezing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Tachypnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Spirometry
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Sarcoidosis<ref name="LiTao2018">{{cite journal|last1=Li|first1=Cheng-Wei|last2=Tao|first2=Ru-Jia|last3=Zou|first3=Dan-Feng|last4=Li|first4=Man-Hui|last5=Xu|first5=Xin|last6=Cao|first6=Wei-Jun|title=Pulmonary sarcoidosis with and without extrapulmonary involvement: a cross-sectional and observational study in China|journal=BMJ Open|volume=8|issue=2|year=2018|pages=e018865|issn=2044-6055|doi=10.1136/bmjopen-2017-018865}}</ref>
| | |[[SAPS III]] |
| | align="center" |Acute/subacute/chronic
| | |[[Widget:SAPSIII]] |
| | align="center" |20−40 years old
| |
| | align="center" |Female
| |
| | align="center" | +
| |
| | align="center" |±
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | align="center" |±
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |±
| |
| | align="center" | −
| |
| | | |
| * [[Rales|Crackles]]
| |
| * [[Wheeze|Wheezing]]
| |
| * Decreased [[breath sounds]]
| |
| | align="center" | +
| |
| | align="center" | −
| |
| |
| |
| * [[Hypercalciuria]]
| |
| * [[Hypercalcemia]]
| |
| * High [[Angiotensin-converting enzyme|ACE]]
| |
| * [[Hypergammaglobulinemia]]
| |
| |
| |
| * [[Hilar lymphadenopathy|Hilar adenopathy]]
| |
| * Reticular opacities
| |
| * [[Pneumothorax]]
| |
| * [[Pleural cavity|Pleural]] thickening
| |
| * [[Chylothorax]]
| |
| * [[Pulmonary hypertension]]
| |
| |
| |
| * ↓ [[Lung volumes|TLC]]
| |
| * ↓ [[Vital capacity|FVC]]
| |
| * ↓ [[Spirometry|FEV1]]
| |
| * ↑ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| * ↓ [[DLCO]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| * ↓ CO2
| |
| * [[Respiratory acidosis]]
| |
| |
| |
| * [[Lymphocytosis]]
| |
| * Elevated [[adenosine deaminase]]
| |
| * [[D-dimer]] +
| |
| |
| |
| * Clinical evaluation and investigations
| |
| |- | | |- |
| ! rowspan="2" style="background:#DCDCDC;" align="center" |Granulomatous vasculitides
| | |[[PIM2]] |
| ! style="background:#DCDCDC;" align="center" |Granulomatosis with polyangiitis (Wegener)<ref name="pmid26684637">{{cite journal |vauthors=Greco A, Marinelli C, Fusconi M, Macri GF, Gallo A, De Virgilio A, Zambetti G, de Vincentiis M |title=Clinic manifestations in granulomatosis with polyangiitis |journal=Int J Immunopathol Pharmacol |volume=29 |issue=2 |pages=151–9 |date=June 2016 |pmid=26684637 |pmc=5806708 |doi=10.1177/0394632015617063 |url=}}</ref>
| |
| | align="center" |Chronic
| |
| | align="center" |Elderly
| |
| | align="center" |Both
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |±
| |
| | align="center" | −
| |
| | | | | |
| * [[Rales|Crackles]]
| | |} |
| | align="center" | − | | ==Table== |
| | align="center" | −
| | {| |
| |
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Complications |
| * [[Anti-neutrophil cytoplasmic antibody|ANCA]] +
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Polymyositis |
| * [[Anemia]]
| | ! align="center" style="background:#4479BA; color: #FFFFFF;" + |Dermatomyositis |
| * [[Leukocytosis]]
| |
| * [[Thrombocytosis]]
| |
| * Elevated [[Erythrocyte sedimentation rate|ESR]]
| |
| * Elevated [[C-reactive protein|CRP]]
| |
| * Elevated [[creatinine]]
| |
| * Urine [[protein]] +
| |
| * [[Hematuria]]
| |
| | | |
| * Cavitate [[Nodule (medicine)|nodules]]
| |
| * Ground−glass opacity
| |
| * [[Consolidation (medicine)|Consolidation]]
| |
| * [[Pleural effusion]]
| |
| * [[Hilar lymphadenopathy|Hilar adenopathy]]
| |
| |
| |
| * ↓ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * Alveolar hemorrhage
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! style="background:#DCDCDC;" align="center" |Eosinophilic granulomatosis with polyangiitis (Churg Strauss)<ref name="pmid25500434">{{cite journal |vauthors=Greco A, Rizzo MI, De Virgilio A, Gallo A, Fusconi M, Ruoppolo G, Altissimi G, De Vincentiis M |title=Churg-Strauss syndrome |journal=Autoimmun Rev |volume=14 |issue=4 |pages=341–8 |date=April 2015 |pmid=25500434 |doi=10.1016/j.autrev.2014.12.004 |url=}}</ref> | | ! align="center" style="background:#DCDCDC;" + |[[Cancer|Malignancy]] |
| | align="center" |Chronic
| | | align="left" style="background:#F5F5F5;" + | |
| | align="center" |40−50 years old
| | *[[Lung]] |
| | align="center" |Both
| | | align="left" style="background:#F5F5F5;" + | |
| | align="center" | +
| | *[[Lung]] |
| | align="center" | − | | |} |
| | align="center" | − | | <br> |
| | align="center" | −
| | ===Calculation of the Padua Prediction Score=== |
| | align="center" | −
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | | |
| * Scattered [[Wheeze|wheezing]] | |
| | align="center" | − | |
| | align="center" | −
| |
| | | |
| * [[Eosinophilia]] | |
| * Elevated [[Immunoglobulin E|IgE]] titers
| |
| * [[Anti-neutrophil cytoplasmic antibody|ANCA]] +
| |
| |
| |
| * Areas of parenchymal opacification
| |
| * Mixed interstitial patchy [[Alveolus|alveolar]] opacities
| |
| |
| |
| * ↓ [[Lung volumes|TLC]]
| |
|
| |
|
| * ↑ [[Residual volume|RV]]
| | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| | | | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| * Normal
| |
| |
| |
| * [[Eosinophilia]]
| |
| | | |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Bronchocentric granulomatosis<ref name="Myers1989">{{cite journal|last1=Myers|first1=Jeffrey L.|title=Bronchocentric Granulomatosis|journal=Chest|volume=96|issue=1|year=1989|pages=3–4|issn=00123692|doi=10.1378/chest.96.1.3}}</ref> | | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| | align="center" |Chronic
| | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| | align="center" |30−70 years old
| |
| | align="center" |Both
| |
| | align="center" | −
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |±
| |
| | align="center" |±
| |
| | align="center" | +
| |
| | align="center" |±
| |
| | align="center" | −
| |
| |
| |
| * Scattered [[Wheeze|wheezing]]
| |
| | align="center" | −
| |
| | align="center" |−
| |
| |
| |
| * [[Eosinophilia]]
| |
| * Elevated [[Immunoglobulin E|IgE]] titers
| |
| * Elevated circulating IgE antibodies to [[Aspergillus]] species
| |
| |
| |
| * Upper zone single or multiple pulmonary [[Nodule (medicine)|nodules]]
| |
| * [[Consolidation (medicine)|Consolidation]]
| |
| * [[Atelectasis]]
| |
| |
| |
| * ↓ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * Normal
| |
| |
| |
| * [[Eosinophilia]]
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Pulmonary lymphomatoid granulomatosis<ref name="AnkitaShashi2016">{{cite journal|last1=Ankita|first1=Grover|last2=Shashi|first2=Dhawan|title=Pulmonary Lymphomatoid Granulomatosis- a Case Report with Review of Literature|journal=Indian Journal of Surgical Oncology|volume=7|issue=4|year=2016|pages=484–487|issn=0975-7651|doi=10.1007/s13193-016-0525-1}}</ref> | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active gastric or duodenal ulcer |
| | align="center" |Chronic
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4.5 |
| | align="center" |30−50 years old | |
| | align="center" |Male
| |
| | align="center" | −
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" |−
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" | +
| |
| | align="center" |−
| |
| |
| |
| * Normal
| |
| | align="center" |−
| |
| | align="center" |−
| |
| |
| |
| * [[Epstein Barr virus|Epstein-Barr virus]] (EBV) serology +
| |
| |
| |
| * Mid to lower zone multiple poorly defined [[Nodule (medicine)|nodules]]
| |
| * Diffuse reticular abnormalities
| |
| |
| |
| * Normal
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| * Chronic [[respiratory alkalosis]]
| |
| |
| |
| * Normal
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" style="background:#DCDCDC;" align="center" |Amyloidosis<ref name="KhoorColby2017">{{cite journal|last1=Khoor|first1=Andras|last2=Colby|first2=Thomas V.|title=Amyloidosis of the Lung|journal=Archives of Pathology & Laboratory Medicine|volume=141|issue=2|year=2017|pages=247–254|issn=0003-9985|doi=10.5858/arpa.2016-0102-RA}}</ref><ref name="MilaniBasset2017">{{cite journal|last1=Milani|first1=Paolo|last2=Basset|first2=Marco|last3=Russo|first3=Francesca|last4=Foli|first4=Andrea|last5=Palladini|first5=Giovanni|last6=Merlini|first6=Giampaolo|title=The lung in amyloidosis|journal=European Respiratory Review|volume=26|issue=145|year=2017|pages=170046|issn=0905-9180|doi=10.1183/16000617.0046-2017}}</ref> | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Prior bleeding within the last 3 months |
| | align="center" |Subacute/chronic
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| | align="center" |50−70 years old | |
| | align="center" |Male
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | align="center" | −
| |
| | align="center" | Bloody
| |
| | align="center" | +
| |
| | align="center" | −
| |
| | align="center" | −
| |
| |
| |
| * [[Rales|Crackles]]
| |
| | align="center" | −
| |
| | align="center" | −
| |
| |
| |
| * Congophilia with apple−green birefringence under polarized light
| |
| |
| |
| * Tracheobronchial infiltration
| |
| * Persistent [[Pleural effusion|pleural effusions]]
| |
| * Parenchymal [[Nodule (medicine)|nodules]]
| |
| |
| |
| * ↓ [[FEV1/FVC ratio|FEV1/FVC]]
| |
| |
| |
| * ↓ [[Oxygen|O2]]
| |
| |
| |
| * Normal
| |
| |
| |
| * Lung [[biopsy]]
| |
| |- | | |- |
| ! colspan="2" rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Disease | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Thrombocytopenia (<50x10<sup>9</sup>/L) |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |History
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |4 |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Symptoms
| |
| ! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" |Physical examination
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Lab findings
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Imaging
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Pulmonary function test
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Bronchoscopy and BAL
| |
| ! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Gold standard
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Duration | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age ≥ 85 years |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Age
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |3.5 |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Gender
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Family history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Smoking history
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Environmental exposure
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |HIV
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Dyspnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cough
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Wheezing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Chest pain
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Tachypnea
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Auscultation
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cyanosis
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Clubbing
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Spirometry
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |ABG
| |
| |} | |
| </small></small>
| |
| | |
| == Diagnosis ==
| |
| * There are multiple laboratory tests that might be helpful to ascertain or rule out the diagnosis of interstitial lung disease.
| |
| {| class="wikitable"
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Condition
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Disease
| |
| ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" |Test
| |
| |- | | |- |
| | colspan="2" rowspan="7" |All patients with suspicious interstitial lung disease
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Liver failure (INR>1.5) |
| | colspan="2" |[[Complete blood count]] and differential | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |- | | |- |
| | rowspan="3" |[[Liver function tests]]
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Severe kidney failure (GFR< 30 mL/min/m<sup>2</sup>) |
| |[[Alanine transaminase|Alanine aminotransferase]] (ALT, SGPT) | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |- | | |- |
| |[[Aspartate transaminase|Aspartate aminotransferase]] (AST, SGOT) | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Admission to ICU or CCU |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2.5 |
| |- | | |- |
| |[[Alkaline phosphatase]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Central venous catheter |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| |- | | |- |
| | rowspan="3" |[[Renal function tests]]
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Rheumatic disease |
| |[[Urine|Urinalysis]] | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| |- | | |- |
| |[[Blood urea nitrogen]] (BUN) | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Active malignancy |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |2 |
| |- | | |- |
| |[[Creatinine]] (Cr) | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age: 40-84 years |
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1.5 |
| |- | | |- |
| | rowspan="7" |Suspicious of systemic [[rheumatic disease]]
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| |[[Rheumatoid arthritis|RA]] | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| |[[Serology]]
| |
| |[[Anti-citrullinated protein antibody|Anti−cyclic citrullinated peptide]] (Anti-CCP)
| |
| |- | | |- |
| |[[SLE]] | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Moderate kidney failure (GFR: 30-59 mL/min/m<sup>2</sup>) |
| |[[Serology]] | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |1 |
| |[[Anti-dsDNA antibody|Anti−double stranded DNA antibodies]] (Anti-dsDNA antibody)
| |
| |- | | |- |
| |[[Dermatomyositis|Amyopathic dermatomyositis]]
| | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| |[[Serology]]
| |
| |Anti-melanoma differentiation-associated gene 5 (MDA-5)
| |
| |- | | |- |
| | rowspan="4" |Nonspecific
| | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| |[[Serology]] | | |} |
| |[[Anti-nuclear antibody|Antinuclear antibody]] (ANA) | | <br style="clear:left" /> |
| | |
| | ===Calculation of the test Prediction Score=== |
| | Shown below is a calculator using the predictive score for VTE among hospitalized medical patients. Check all boxes that apply to your patient: |
| | |
| | {| style="border: 0; float: left; width: 45%; position: float; background: #104E8B; border-radius: 10px 10px 10px 10px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5); margin: 0 0 0 0; padding: 5px 5px; font-weight: bold;" |
| | | colspan="2" style="text-align: center; color: #FFFFFF; font-size: 120%;" | IMPROVE Bleeding Risk Score |
| |- | | |- |
| |[[Serology]] | | ! style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Variable |
| |[[Rheumatoid factor]] (RF)
| | ! style=" text-align: center; color: #4479BA; background: #FFFFFF; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Score |
| |- | | |- |
| |[[Serology]] | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Gender |
| |[[Anti-neutrophil cytoplasmic antibody]] (ANCA) | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Female |
| |- | | |- |
| |[[Enzyme]] | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Male |
| |[[Creatine kinase]] (CK), [[aldolase]]
| |
| |- | | |- |
| | rowspan="3" |Mechanic hands
| | ! rowspan="4" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Age |
| | rowspan="3" |[[Myositis]]
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |0-70 |
| | rowspan="3" |Myositis−associated antibodies | |
| |Anti-tRNA synthetases Jo-1
| |
| |- | | |- |
| |Anti-tRNA synthetases PL-7 | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |71-80 |
| |- | | |- |
| |Anti-tRNA synthetases PL-12 | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |81-90 |
| |- | | |- |
| | rowspan="4" |[[Sicca syndrome|Sicca]] features or positive anti−extractable nuclear antigen (ENA) | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>90 |
| | rowspan="2" |[[Sjögren's syndrome|Sjögren’s syndrome]]
| |
| |[[Serology]]
| |
| |Anti-RO (SS−A)
| |
| |- | | |- |
| |[[Serology]] | | ! rowspan="5" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Hgb ('''g/dL)''' |
| |Anti-La (SS−B) | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>17 '''g/dL''' |
| |- | | |- |
| |[[Mixed connective tissue disease]] | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15.5-17 '''g/dL''' |
| |[[Serology]]
| |
| |Anti-ribonucleoprotein (RNP)
| |
| |- | | |- |
| |IgG4-related disease | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-15.5 '''g/dL''' |
| |[[Serology]] | |
| |Serum IgG4
| |
| |- | | |- |
| | rowspan="2" |Severe GERD or sclerodactyly | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |12.5-11 '''g/dL''' |
| |Limited systemic scleroderma
| |
| |[[Serology]]
| |
| |Anti-centromere
| |
| |- | | |- |
| |Systemic scleroderma | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<11 '''g/dL''' |
| |[[Serology]]
| |
| |Anti-topoisomerase I (anti-Scl-70)
| |
| |- | | |- |
| | rowspan="2" |Dyspnea
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |CrCl (mL/min) |
| |Heart failure
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |30-60 mL/min |
| | rowspan="2" |[[Enzyme]]
| |
| |Brain natriuretic peptide (BNP) | |
| |- | | |- |
| |Pulmonary hypertension | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |15-30 mL/min |
| |N-terminal proBNP (NT-proBNP)
| |
| |- | | |- |
| | rowspan="4" |Anemia and/or hemoptysis
| | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Albumin |
| |[[Coagulopathy|Coagulopathies]]
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |>3.5 g/dL |
| | colspan="2" |[[Coagulation|Coagulation studies]] | |
| |- | | |- |
| |Goodpasture syndrome | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≤3.5 g/dL |
| |[[Serology]]
| |
| |Anti−glomerular basement membrane (GBM) antibodies
| |
| |- | | |- |
| |Antiphospholipid syndrome | | ! rowspan="2" style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |D-dimer |
| |[[Serology]] | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |≥1 µg/mL |
| |Antiphospholipid antibodies | |
| |- | | |- |
| |Idiopathic pulmonary hemosiderosis | | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |<1 µg/mL |
| |[[Serology]] | |
| |Serum IgA endomysial or tissue transglutaminase antibodies
| |
| |- | | |- |
| |Mediastinal lymphadenopathy | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |ICU admission |
| |Multiple myeloma
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | colspan="2" |Serum protein electrophoresis | |
| |- | | |- |
| |Beryllium exposure | | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Acute stroke on hospitalization |
| |Berylliosis
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | colspan="2" |Peripheral blood beryllium lymphocyte proliferation test | |
| |- | | |- |
| | rowspan="2" |Risk factors for HIV
| | ! style=" text-align: left; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |History of VTE |
| | rowspan="2" |HIV
| | | style=" text-align: center; color: #FFFFFF; background: #4479BA; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 -1px 0 rgba(0, 0, 0, 0.5); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" | |
| | colspan="2" |ELISA | |
| |- | | |- |
| | colspan="2" |Western blot test
| | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Result: |
| |}
| |
| | |
| == Occupational lung disease ==
| |
| * [[Occupational lung disease|Occupational lung diseases]] are caused by the accumulation of different dust particles in the [[Alveolus|alveolar]] space.<ref name="pmid10931786">{{cite journal| author=Castranova V, Vallyathan V| title=Silicosis and coal workers' pneumoconiosis. | journal=Environ Health Perspect | year= 2000 | volume= 108 Suppl 4 | issue= | pages= 675-84 | pmid=10931786 | doi= | pmc=PMC1637684 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10931786 }} </ref>
| |
| * As the particles accumulate, the body's elimination mechanisms begin to fail, resulting in activation of [[Chemotaxis|chemotactic]] factors that exacerbate the [[Inflammation|inflammatory]] response, and subsequently lead to [[fibrosis]].
| |
| * The most common particles that cause [[pneumoconiosis]] are [[asbestos]], [[silica]], coal, magnesium silicate, aluminum silicate, [[bauxite]], [[cobalt]], [[beryllium]] and [[iron]].
| |
| '''For more information about occupational lung disease, [[Occupational lung disease|click here]].'''
| |
| | |
| == Drug−induced lung injury==
| |
| * More than 600 medications might be [[Pulmonary toxicity|pulmonary toxic]] and cause [[lung]] injury.<ref name="CamusBonniaud2004">{{cite journal|last1=Camus|first1=Philippe|last2=Bonniaud|first2=Philippe|last3=Fanton|first3=Annlyse|last4=Camus|first4=Clio|last5=Baudaun|first5=Nicolas|last6=Foucher|first6=Pascal|title=Drug-induced and iatrogenic infiltrative lung disease|journal=Clinics in Chest Medicine|volume=25|issue=3|year=2004|pages=479–519|issn=02725231|doi=10.1016/j.ccm.2004.05.006}}</ref>
| |
| * [[Lung]] injury following medication intake might vary from interstitial lung disease to [[hypersensitivity pneumonitis]], [[pleural effusion]] or [[pulmonary edema]].<ref name="pmid8484641">{{cite journal |vauthors=Todd NW, Peters WP, Ost AH, Roggli VL, Piantadosi CA |title=Pulmonary drug toxicity in patients with primary breast cancer treated with high-dose combination chemotherapy and autologous bone marrow transplantation |journal=Am. Rev. Respir. Dis. |volume=147 |issue=5 |pages=1264–70 |date=May 1993 |pmid=8484641 |doi=10.1164/ajrccm/147.5.1264 |url=}}</ref><ref name="pmid15062605">{{cite journal |vauthors=Schwarz MI, Fontenot AP |title=Drug-induced diffuse alveolar hemorrhage syndromes and vasculitis |journal=Clin. Chest Med. |volume=25 |issue=1 |pages=133–40 |date=March 2004 |pmid=15062605 |doi=10.1016/S0272-5231(03)00139-4 |url=}}</ref>
| |
| * The presentation of [[lung]] injury might be acute, subacute or chronic and it might occur weeks to years even after discontinuing the drug.<ref name="pmid9493644">{{cite journal |vauthors=De Vuyst P, Pfitzenmeyer P, Camus P |title=Asbestos, ergot drugs and the pleura |journal=Eur. Respir. J. |volume=10 |issue=12 |pages=2695–8 |date=December 1997 |pmid=9493644 |doi= |url=}}</ref><ref name="pmid20592596">{{cite journal |vauthors=Wijnen PA, Bekers O, Drent M |title=Relationship between drug-induced interstitial lung diseases and cytochrome P450 polymorphisms |journal=Curr Opin Pulm Med |volume=16 |issue=5 |pages=496–502 |date=September 2010 |pmid=20592596 |doi=10.1097/MCP.0b013e32833c06f1 |url=}}</ref>
| |
| * Diagnosis of drug-induced lung injury is by the exclusion of other diseases. Detailed history and paraclinical [[Lung|pulmonary]] investigations are required to exclude other causes of interstitial lung disease. [[Lung|Pulmonary]] investigations are as follow:<ref name="Matsuno2012">{{cite journal|last1=Matsuno|first1=Osamu|title=Drug-induced interstitial lung disease: mechanisms and best diagnostic approaches|journal=Respiratory Research|volume=13|issue=1|year=2012|pages=39|issn=1465-9921|doi=10.1186/1465-9921-13-39}}</ref>
| |
| ** On [[Spirometry|pulmonary function tests]] ([[Spirometry|PFTs]]), a [[Restrictive lung disease|restrictive pattern]] is more common. [[FEV1/FVC ratio]] may be normal or increased. [[DLCO]] is reduced.
| |
| ** [[Bronchoalveolar lavage]] may exclude [[Infection|infectious]] disease.
| |
| ** [[Bronchoscopy]] with transbronchial [[biopsy]] may be indicated to exclude other diseases that have [[Lung|pulmonary]] involvement.
| |
| ** Invasive lung [[biopsy]] is rarely required.
| |
| * Management of drug-induced lung injury includes:<ref name="pmid205227932">{{cite journal |vauthors=Gingo MR, George MP, Kessinger CJ, Lucht L, Rissler B, Weinman R, Slivka WA, McMahon DK, Wenzel SE, Sciurba FC, Morris A |title=Pulmonary function abnormalities in HIV-infected patients during the current antiretroviral therapy era |journal=Am. J. Respir. Crit. Care Med. |volume=182 |issue=6 |pages=790–6 |date=September 2010 |pmid=20522793 |pmc=2949404 |doi=10.1164/rccm.200912-1858OC |url=}}</ref>
| |
| ** Immediate drug discontinuation
| |
| ** Supportive therapy
| |
| ** Control of other underlying chronic [[Pulmonology|pulmonary disease]]
| |
| ** Treatment of [[Respiratory tract infection|respiratory infections]]
| |
| ** [[Smoking cessation]]
| |
| ** [[Glucocorticoid]] therapy<ref name="pmid7842781">{{cite journal |vauthors=Kalaycioglu M, Kavuru M, Tuason L, Bolwell B |title=Empiric prednisone therapy for pulmonary toxic reaction after high-dose chemotherapy containing carmustine (BCNU) |journal=Chest |volume=107 |issue=2 |pages=482–7 |date=February 1995 |pmid=7842781 |doi= |url=}}</ref>
| |
| * List of medications that might cause interstitial lung disease is as follow:<ref name="Schwaiblmair2012">{{cite journal|last1=Schwaiblmair|first1=Martin|title=Drug Induced Interstitial Lung Disease|journal=The Open Respiratory Medicine Journal|volume=6|issue=1|year=2012|pages=63–74|issn=18743064|doi=10.2174/1874306401206010063}}</ref><ref name="pmid25546981">{{cite journal |vauthors=Vasić NR, Milenković BA, Pešut DP, Stević RS, Jovanović DM |title=Drug induced lung disease--amiodarone in focus |journal=Med. Pregl. |volume=67 |issue=9-10 |pages=334–7 |date=2014 |pmid=25546981 |doi= |url=}}</ref>
| |
| {| class="wikitable"
| |
| ! colspan="7" style="background:#4479BA; color: #FFFFFF;" align="center" |Drug−induced lung injury
| |
| |- | | |- |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Antimicrobial Agents | | ! colspan="2" style=" text-align: left; color: #4479BA; background: #FFFFFF; padding: 2px 10px; border-radius: 5px 5px 5px 5px; text-shadow: 0 0 0 rgba(0, 0, 0, 0.2); box-shadow: 0 1px 1px rgba(0, 0, 0, 0.5);" |Interpretation: |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Anti−Inflammatory Agents
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Biological Agents
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Cardiovascular Agents
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Immunomodulator agents
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Antineoplastic agents
| |
| ! style="background:#4479BA; color: #FFFFFF;" align="center" |Miscellaneous
| |
| |- valign="top"
| |
| |
| |
| * [[Amphotericin B]]
| |
| * [[Doripenem]]
| |
| * [[Ethambutol]]
| |
| * [[Isoniazid]]
| |
| * [[Minocycline]]
| |
| * [[Nitrofurantoin]]
| |
| * [[Sulfasalazine]]
| |
| |
| |
| * [[Abatacept]]
| |
| * [[Aspirin]]
| |
| * [[Azathioprine]]
| |
| * [[Cyclophosphamide]]
| |
| * [[Gold]]
| |
| * [[Anakinra]]
| |
| * [[Leflunomide]]
| |
| * [[Methotrexate]]
| |
| * [[Non-steroidal anti-inflammatory drug|Nonsteroidal anti-inflammatory drugs]]
| |
| * [[Penicillamine]]
| |
| * [[Sulfasalazine]]
| |
| * [[Thalidomide]]
| |
| |
| |
| * [[Adalimumab]]
| |
| * [[Alemtuzumab]]
| |
| * [[Interferon type I|Alpha interferon]]
| |
| * [[Bevacizumab]]
| |
| * [[Cetuximab]]
| |
| * [[Etanercept]]
| |
| * [[Infliximab]]
| |
| * [[Panitumumab]]
| |
| * [[Rituximab]]
| |
| * [[Tocilizumab]]
| |
| * [[Trastuzumab]]
| |
| |
| |
| * [[ACE inhibitor|ACE inhibitors]]
| |
| * [[Amiodarone]]<ref name="pmid19399307">{{cite journal |vauthors=Wolkove N, Baltzan M |title=Amiodarone pulmonary toxicity |journal=Can. Respir. J. |volume=16 |issue=2 |pages=43–8 |date=2009 |pmid=19399307 |pmc=2687560 |doi= |url=}}</ref>
| |
| * [[Anticoagulant|Anticoagulants]]
| |
| * [[Beta blockers]]
| |
| * [[Flecainide]]
| |
| * [[Hydrochlorothiazide]]
| |
| * [[Procainamide]]
| |
| * [[Statins]]<ref name="FernándezKaras2008">{{cite journal|last1=Fernández|first1=Antonio B.|last2=Karas|first2=Richard H.|last3=Alsheikh-Ali|first3=Alawi A.|last4=Thompson|first4=Paul D.|title=Statins and Interstitial Lung Disease|journal=Chest|volume=134|issue=4|year=2008|pages=824–830|issn=00123692|doi=10.1378/chest.08-0943}}</ref>
| |
| * [[Tocainide]]
| |
| |
| |
| * [[Sirolimus]]
| |
| * [[Riluzole]]
| |
| * [[Trametinib]]
| |
| * [[vandetanib]]
| |
| |
| |
| <div style="-moz-column-count:2; column-count:2;">
| |
| * [[Azathioprine]]
| |
| * [[Bleomycin]]
| |
| * [[Bortezomib]]
| |
| * [[Busulfan]]
| |
| * [[Carmustine]] (BCNU)<ref name="pmid2370889">{{cite journal |vauthors=O'Driscoll BR, Hasleton PS, Taylor PM, Poulter LW, Gattameneni HR, Woodcock AA |title=Active lung fibrosis up to 17 years after chemotherapy with carmustine (BCNU) in childhood |journal=N. Engl. J. Med. |volume=323 |issue=6 |pages=378–82 |date=August 1990 |pmid=2370889 |doi=10.1056/NEJM199008093230604 |url=}}</ref>
| |
| * [[Chlorambucil]]
| |
| * [[Colony-stimulating factor|Colony-stimulating factors]]
| |
| * [[Crizotinib]]
| |
| * [[Cyclophosphamide]]<ref name="pmid84846412">{{cite journal |vauthors=Todd NW, Peters WP, Ost AH, Roggli VL, Piantadosi CA |title=Pulmonary drug toxicity in patients with primary breast cancer treated with high-dose combination chemotherapy and autologous bone marrow transplantation |journal=Am. Rev. Respir. Dis. |volume=147 |issue=5 |pages=1264–70 |date=May 1993 |pmid=8484641 |doi=10.1164/ajrccm/147.5.1264 |url=}}</ref>
| |
| * [[Cytarabine]]
| |
| * [[Deferoxamine]]
| |
| * [[Docetaxel]]
| |
| * [[Doxorubicin hydrochloride|Doxorubicin]]
| |
| * [[Eribulin]]
| |
| * [[Erlotinib]]
| |
| * [[Etoposide]] (VP−16)
| |
| * [[Fludarabine]]
| |
| * [[Flutamide]]
| |
| * [[Gefitinib]]
| |
| * [[Gemcitabine]]<ref name="pmid23404815">{{cite journal |vauthors=Tamura M, Saraya T, Fujiwara M, Hiraoka S, Yokoyama T, Yano K, Ishii H, Furuse J, Goya T, Takizawa H, Goto H |title=High-resolution computed tomography findings for patients with drug-induced pulmonary toxicity, with special reference to hypersensitivity pneumonitis-like patterns in gemcitabine-induced cases |journal=Oncologist |volume=18 |issue=4 |pages=454–9 |date=2013 |pmid=23404815 |pmc=3639533 |doi=10.1634/theoncologist.2012-0248 |url=}}</ref>
| |
| * [[Hydroxyurea]]
| |
| * [[Imatinib]]
| |
| * [[Lomustine]] (CCNU)
| |
| * [[Melphalan]]
| |
| * [[Mitomycin (patient information)|Mitomycin-C]]
| |
| * [[Nilutamide]]
| |
| * [[Nitrosourea]]
| |
| * [[Olsalazine]]
| |
| * [[Paclitaxel]]
| |
| * [[Procarbazine]]
| |
| * [[Semustine]] (Methyl−CCNU)
| |
| * [[Sorafenib]]
| |
| * [[Vinblastine]]
| |
| |
| |
| * [[BCG vaccine|Bacille Calmette-Guerin]] (BCG)
| |
| * [[Bromocriptine]]
| |
| * [[Carbamazepine]]
| |
| * [[Cabergoline]]
| |
| * [[Cocaine]]<ref name="pmid22934773">{{cite journal |vauthors=Drent M, Wijnen P, Bast A |title=Interstitial lung damage due to cocaine abuse: pathogenesis, pharmacogenomics and therapy |journal=Curr. Med. Chem. |volume=19 |issue=33 |pages=5607–11 |date=2012 |pmid=22934773 |doi= |url=}}</ref>
| |
| * [[Methysergide]]
| |
| * [[Tryptophan|L-tryptophan]]
| |
| * [[Penicillamine]]
| |
| * [[Phenytoin]]
| |
| * [[Talcosis|Talc]]
| |
| |} | | |} |
| | <br style="clear:left" /> |
|
| |
|
| == Radiation-induced lung injury == | | ===Interpretation of the Padua Prediction Score=== |
| [[Radiation therapy|Radiation]] has been considered as one of the causes of [[lung]] injury. About 5 to 15% of patients receiving [[radiation therapy]] may present [[Lung|pulmonary]] symptoms.<ref name="MalaviyaGow2015">{{cite journal|last1=Malaviya|first1=Rama|last2=Gow|first2=Andrew J.|last3=Francis|first3=Mary|last4=Abramova|first4=Elena V.|last5=Laskin|first5=Jeffrey D.|last6=Laskin|first6=Debra L.|title=Radiation-Induced Lung Injury and Inflammation in Mice: Role of Inducible Nitric Oxide Synthase and Surfactant Protein D|journal=Toxicological Sciences|volume=144|issue=1|year=2015|pages=27–38|issn=1096-0929|doi=10.1093/toxsci/kfu255}}</ref>
| | The interpretation of the score is as follows: |
| * [[Lung|Pulmonary]] injury following [[irradiation]] is directly related to duration and dose of [[Radiation therapy|radiation]].<ref name="pmid16015535">{{cite journal |vauthors=Kong FM, Ten Haken R, Eisbruch A, Lawrence TS |title=Non-small cell lung cancer therapy-related pulmonary toxicity: an update on radiation pneumonitis and fibrosis |journal=Semin. Oncol. |volume=32 |issue=2 Suppl 3 |pages=S42–54 |date=April 2005 |pmid=16015535 |doi= |url=}}</ref>
| | * Score ≥ 4: High risk for VTE |
| * The main pathogenesis of radiation-induced lung injury is the damage to the type I [[Pneumocyte|pneumocytes]] which triggers the initiation of reactions. It leads to secretion of [[Growth factor|growth factors]] and [[Protease|proteases]] which increases degradation of [[extracellular matrix]]. Also, radiation causes damage to [[Epithelium|epithelial cells]] which leads to loss of barrier function. All of these changes cause a cycle of [[inflammation]] and [[fibrosis]].<ref name="pmid25854336">{{cite journal |vauthors=Giridhar P, Mallick S, Rath GK, Julka PK |title=Radiation induced lung injury: prediction, assessment and management |journal=Asian Pac. J. Cancer Prev. |volume=16 |issue=7 |pages=2613–7 |date=2015 |pmid=25854336 |doi= |url=}}</ref>
| | * Score < 4: Low risk for VTE |
| * There are two types of reaction in [[Lung|pulmonary]] tissues to [[Radiation therapy|radiation]] which include:<ref name="pmid17126203">{{cite journal |vauthors=Tsoutsou PG, Koukourakis MI |title=Radiation pneumonitis and fibrosis: mechanisms underlying its pathogenesis and implications for future research |journal=Int. J. Radiat. Oncol. Biol. Phys. |volume=66 |issue=5 |pages=1281–93 |date=December 2006 |pmid=17126203 |doi=10.1016/j.ijrobp.2006.08.058 |url=}}</ref>
| | ==References== |
| ** Early [[Lung|pulmonary]] reaction: | | <references /> |
| *** It usually occurs in 4 to 12 weeks following [[irradiation]].
| |
| *** Early reaction mostly presents as radiation [[pneumonitis]].
| |
| *** Treatment of radiation [[pneumonitis]] include [[Steroid|steroids]], [[ACE inhibitor|ACE inhibitors]] and [[pentoxifylline]].
| |
| ** Late [[Lung|pulmonary]] reaction:
| |
| *** It usually occurs 6 to 12 months following [[irradiation]].
| |
| *** Late response usually induces lung [[fibrosis]].
| |
| *** Management of lung [[fibrosis]] consists of supportive therapy, [[airway]] secretions mobilization, anti-inflammatory therapy, and management of acute exacerbations.
| |
| * [[Computed tomography|CT]] might be used for the diagnosis of radiation [[pneumonitis]]. Ground glass opacities, [[Consolidation (medicine)|consolidation]], [[fibrosis]], [[atelectasis]], pulmonary volume loss, or [[Pleural cavity|pleural]] thickening might be seen on [[Computed tomography|CT scan]].
| |
| | |
| == Smoking related interstitial lung disease ==
| |
| Cigarette smoking may cause various adverse effects on pulmonary tissue.
| |
| * Cigarette smoke might injure alveolar epithelial cells leading to in diffuse infiltration and subsequently parenchymal fibrosis.
| |
| * There is a well-known association with tobacco smoking and
| |
| | |
| * Desquamative interstitial pneumonia<ref>{{cite journal |last=Nagai |first=Sonoko |coauthors=Yuma Hoshino, Michio Hayashi, Isao Ito |title=Smoking-related interstitial lung diseases |url=http://www.co-pulmonarymedicine.com/pt/re/copulmonary/abstract.00063198-200009000-00005.htm |journal=Current Opinion in Pulmonary Medicine |volume=6 |issue=5 |pages=415-9 |year=2000 |pmid=10958232}}</ref><ref>{{cite journal |last=Baumgartner |first=KB |coauthors=Samet JM, Stidley CA, Colby TV, Waldron JA |title=Cigarette smoking: a risk factor for idiopathic pulmonary fibrosis |url= http://ajrccm.atsjournals.org/cgi/content/short/155/1/242 |journal=American Journal of Respiratory and Critical Care Medicine |volume=155 |number=1 |pages=242-248 |year=1997 |pmid=9001319}}</ref> | |
| * Respiratory bronchiolitis–associated interstitial lung disease
| |
| * Pulmonary Langerhans cell granulomatosis
| |
| | |
| == Idiopathic interstitial pneumonias == | |
| The idiopathic interstitial pneumonias (IIP) are a broad range of interstitial lung diseases of unknown etiology.<ref name="Selman">{{cite journal |last=Selman |first=Moisés |coauthors=Talmadge E. King, Jr.; and Annie Pardo |title=Idiopathic pulmonary fibrosis: prevailing and evolving hypotheses about its pathogenesis and implications for therapy |journal=Annals of Internal Medicine |year=2001 |volume=134 |number=2 |pages=136-51|url=http://www.annals.org/cgi/content/abstract/134/2/136}}</ref><ref>{{cite journal |last=King, Jr. |first=Talmadge E. |title=Centennial review: clinical advances in the diagnosis and therapy of the interstitial lung diseases|url=http://ajrccm.atsjournals.org/cgi/content/full/172/3/268 |journal=American Journal of Respiratory and Critical Care Medicine |year=2005 |volume=172 |number=3 |pages=268-79}}</ref><ref name="Flaherty-2001">{{Cite journal | last1 = Flaherty | first1 = KR. | last2 = Travis | first2 = WD. | last3 = Colby | first3 = TV. | last4 = Toews | first4 = GB. | last5 = Kazerooni | first5 = EA. | last6 = Gross | first6 = BH. | last7 = Jain | first7 = A. | last8 = Strawderman | first8 = RL. | last9 = Flint | first9 = A. | title = Histopathologic variability in usual and nonspecific interstitial pneumonias. | journal = Am J Respir Crit Care Med | volume = 164 | issue = 9 | pages = 1722-7 | month = Nov | year = 2001 | doi = 10.1164/ajrccm.164.9.2103074 | PMID = 11719316 }}</ref><ref name="Cottin-1998">{{Cite journal | last1 = Cottin | first1 = V. | last2 = Donsbeck | first2 = AV. | last3 = Revel | first3 = D. | last4 = Loire | first4 = R. | last5 = Cordier | first5 = JF. | title = Nonspecific interstitial pneumonia. Individualization of a clinicopathologic entity in a series of 12 patients. | journal = Am J Respir Crit Care Med | volume = 158 | issue = 4 | pages = 1286-93 | month = Oct | year = 1998 | doi = 10.1164/ajrccm.158.4.9802119 | PMID = 9769293 }}</ref><ref name="Park-1996">{{Cite journal | last1 = Park | first1 = CS. | last2 = Jeon | first2 = JW. | last3 = Park | first3 = SW. | last4 = Lim | first4 = GI. | last5 = Jeong | first5 = SH. | last6 = Uh | first6 = ST. | last7 = Park | first7 = JS. | last8 = Choi | first8 = DL. | last9 = Jin | first9 = SY. | title = Nonspecific interstitial pneumonia/fibrosis: clinical manifestations, histologic and radiologic features. | journal = Korean J Intern Med | volume = 11 | issue = 2 | pages = 122-32 | month = Jun| year = 1996 | doi = | PMID = 8854648 }}</ref><ref name="Shimizu-2002">{{Cite journal | last1 = Shimizu | first1 = S. | last2 = Yoshinouchi | first2 = T. | last3 = Ohtsuki | first3 = Y. | last4 = Fujita | first4 = J. |last5 = Sugiura | first5 = Y. | last6 = Banno | first6 = S. | last7 = Yamadori | first7 = I. | last8 = Eimoto | first8 = T. | last9 = Ueda | first9 = R. | title = The appearance of S-100 protein-positive dendritic cells and the distribution of lymphocyte subsets in idiopathic nonspecific interstitial pneumonia. | journal = Respir Med | volume = 96 | issue = 10 | pages = 770-6 | month = Oct | year = 2002 | doi = | PMID = 12412975 }}</ref>
| |
| *Pathogenesis of all idiopathic interstitial pneumonias are [[Fibroblast|fibroblasts]] proliferation and [[collagen]] deposition leading to [[inflammation]] and [[fibrosis]].
| |
| *Patients with idiopathic interstitial pneumonias generally manifests as a gradual [[dyspnea]] and dry [[cough]].
| |
| *On chest imagings it is characterized by bilateral abnormal opacities of various types.
| |
| *The most common is chronic [[Idiopathic pulmonary fibrosis]]. However, the worst prognosis is the [[Hamman-Rich syndrome|acute interstitial pneumonia]].
| |
| *The [[diagnosis]] can only be reached correctly with a multidisciplinary approach after excluding known causes.
| |
| *The new classification of idiopathic interstitial pneumonias is as follow:
| |
| ** Major idiopathic interstitial pneumonias
| |
| *** [[Idiopathic pulmonary fibrosis]]
| |
| *** Idiopathic nonspecific interstitial pneumonia
| |
| *** [[Respiratory bronchiolitis-interstitial lung disease]]
| |
| *** [[Desquamative interstitial pneumonia]]
| |
| *** [[Cryptogenic organizing pneumonia]]
| |
| *** [[Hamman-Rich syndrome|Acute interstitial pneumonia]]
| |
| ** Rare idiopathic interstitial pneumonias
| |
| *** Idiopathic [[lymphoid interstitial pneumonia]]
| |
| *** Idiopathic pleuroparenchymal fibroelastosis
| |
| ** Unclassifiable idiopathic interstitial pneumonias
| |
| '''For more information about Idiopathic interstitial pneumonia, [[Idiopathic interstitial pneumonia|click here]].'''
| |
| | |
| '''For more information about idiopathic pulmonary fibrosis, [[Idiopathic pulmonary fibrosis|click here]].'''
| |
| | |
| '''For more information about Cryptogenic organizing pneumonia, [[Cryptogenic organizing pneumonia|click here]].'''
| |
| | |
| == Pulmonary alveolar proteinosis ==
| |
| For more information about pulmonary alveolar proteinosis, '''[[Pulmonary alveolar proteinosis|click here]].'''
| |
| | |
| == Lymphocytic infiltrative disorders ==
| |
| * Lymphocytic interstitial pneumonitis
| |
| * Pulmonary lymphomatoid granulomatosis
| |
| For more information about lymphocytic interstitial pneumonitis, '''[[Lymphocytic interstitial pneumonitis|click here]].'''
| |
| | |
| == Pulmonary lymphangioleiomyomatosis ==
| |
| * For more information about pulmonary lymphangioleiomyomatosis, '''[[Lymphangiomyomatosis|click here]].'''
| |
| | |
| == Pulmonary hemorrhage syndromes ==
| |
| * Goodpasture syndrome
| |
| * Idiopathic pulmonary hemosiderosis
| |
| * Isolated pulmonary capillaritis
| |
| | |
| == Granulomatous lung response ==
| |
| * Hypersensitivity pneumonitis
| |
| * Sarcoidosis
| |
| * Granulomatous vasculitides
| |
| ** Granulomatosis with polyangiitis (Wegener)
| |
| ** Eosinophilic granulomatosis with polyangiitis (ChurgStrauss)
| |
| * Bronchocentric granulomatosis
| |
| For more information about hypersensitivity pneumonitis, '''[[Hypersensitivity pneumonitis|click here]].'''
| |
| | |
| == Interstitial lung disease associated with systemic diseases ==
| |
| | |
| === Interstitial lung disease associated with connective tissue diseases ===
| |
| * Systemic lupus erythematosus
| |
| * Rheumatoid arthritis
| |
| * Ankylosing spondylitis
| |
| * Systemic sclerosis
| |
| * Sjögren syndrome
| |
| * Polymyositis/dermatomyositis
| |
| | |
| === Interstitial lung disease associated with inherited diseases ===
| |
| * Tuberous sclerosis
| |
| * Neurofibromatosis
| |
| * Niemann−Pick disease
| |
| * Gaucher disease
| |
| * Hermansky−Pudlak syndrome
| |
| | |
| === Interstitial lung disease associated with gastrointestinal or liver diseases ===
| |
| * Crohn disease
| |
| * Primary biliary cirrhosis
| |
| * Chronic active hepatitis
| |
| * Ulcerative colitis
| |
| | |
| === Interstitial lung disease associated with graft−versus−host disease ===
| |
| * Bone marrow transplantation
| |
| * Solid organ transplantation
| |
| | |
| == References ==
| |
| {{reflist|2}}
| |