Fibrosing alveolitis
| Incidental findings | ?RA/scleroderma |
| +ve signs | Clubbing, Dyspnoea, ↑RR, Cyanosis, Fine end insp bibasal creps |
| (Differential) diagnosis | Fibrosing alveolitis |
| Function | ?Pul HT: ↑JVP, loud P2, RV heave |
| Tests |
↑ESR, ANA, RF CXR – basal reticular shadowing ABG – hypoxaemia PFT – restrictive, desaturation after exercise HRCT ± lung biopsy |
Causes
|
Upper Extrinsic allergic alveolitis Ank Spon Old TB |
Middle Sarcoid Beryllium |
Lower CFA Connective tissue disease Pneumoconioses Drugs |
Extensions
Look for splenomegaly (amyloidosis)
Look for splenomegaly (amyloidosis)
Notes
- Connective tissue diseases = RA, systemic sclerosis, SLE, polymyositis/dermatomyositis, ankylosing spondylitis (upper lobe). In RA, fibrosis can also be caused by methotrexate.
- Drug causes = Methotrexate, amiodarone, nitrofurantoin
- Types of pneumonitis: Usual interstitial pneumonia (UIP), desquamative IP, Non-specific IP, lymphoid IP, giant cell IP.
- Rx: Trial of steroids for all, but taper if no response