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the subject of this lecture are
interstitial lung diseases these are non
effective non-malignant
infiltrations of lung parenchyma that is
there are diseases where the alveoli and
the institution the gap between the
alveolar and the pulmonary capillaries
and the rest of the lung is infiltrated
by non effective and non-malignant
cellular Conte and extracellular
components there are a range of diseases
which are in this category the most
important which is lung fibrosis and
sarcoidosis in addition there are
diseases which are responses to inhaled
substances and antigens such as
hypersensitive pneumonitis and
pneumoconiosis and a large range of
unusual and very rare institutional
infection of lung diseases which are
normally included in the il deke
category in general il DS into the
interstitial lung diseases cause a
restrictive lung function pattern that
is they reduce the fev1 and the FV c but
as you can see on this diagram on the
right hand side here that the ratio
between the fev1 an FV c is often
increased and in fact total lung
capacity is reduced as well in general
CT scans are also essential for an
accurate assessment of these types of
diseases palma fibrosis is often a
progressive disease and is actually very
difficult to treat
categorizing IL DS is not
straightforward this is one way of doing
of categorizing io DS and is a useful
way of thinking about them in general so
for example here we have five categories
another on the right hand side you have
pulmonary fibrosis and that has several
different causes it could be idiopathic
which is the commonest cause and means
that we don't know what's causing it
well it can be associated connective
tissue disease such as rheumatoid
arthritis or dermatomyositis in addition
is there a range of our situations where
former fibrosis develops such as
radiotherapy drug associate it was
various drugs after adult respiratory
distress syndrome the other category is
a high percentage
Unitas and these are the Communist
causes of that of farmers lung and bird
fancies lungs and these are immune
reactions to inhaled antigens and is a
form of allergy sarcoidosis the cause of
which is unknown is a disease in which
you get infiltration of the lungs with
granulomas and that can present an acute
disease or a chronic disease and it can
have lung involvement pulmonary
sarcoidosis or involvement of other
organs extra pulmonary sarcoidosis then
there are numerous ease which is their
non-allergic inhaled sorry and non
allergic response to inhale substances
such as coal dust asbestosis which
causes an institutional lung disease of
various different patterns depending on
what the substance is that you're
inhaling and then the others the last
category here are the very rare diseases
which are not going to discuss in any
detail today which are often caused
called institutional lung diseases but
have their own distinct patterns and
types in infiltrations now a very
important component of this diagram are
the arrow is showing that patients with
severe hypersensitivities severe
sarcoidosis of severe pneumoconiosis and
some of the other rare and sistren
diseases with aggressive severe disease
end up with what looks like pulmonary
fibrosis at the end so for example if
you have end-stage sarcoidosis
it actually looks clinically and
Radiesse Imel ER to end stage performer
fibrosis and as a consequence sarcoid
hype sitting Unitas and various
pneumoconiosis
are fought off as causes of pulmonary
fibrosis another important point from
this slide is that there are old names
of some of these disease for example
idiopathic pulmonary fibrosis used to be
called cryptogenic fibroids novel itis
and hypersensitivity pneumonitis used to
be called extrinsic allergic alveoli
tiss these terms are interchangeable now
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you