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of or relating to interstices
inflammation of the lungs; caused by a virus or an allergic reaction

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/01/15 09:34:30」(JST)

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Interstitial lung disease (ILD), also known as diffuse parenchymal lung disease (DPLD),^[1] refers to a group of lung diseases affecting the interstitium (the tissue and space around the air sacs of the lungs). ^[2] It concerns alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues.

The term ILD is used to distinguish these diseases from obstructive airways diseases.

Prolonged ILD may result in pulmonary fibrosis, but this is not always the case. Idiopathic pulmonary fibrosis is one form of "interstitial lung disease".

Causes[edit]

The alveoli

Micrograph of usual interstitial pneumonia (UIP). UIP is the most common pattern of idiopathic interstitial pneumonia (a type of interstitial lung disease) and usually represents idiopathic pulmonary fibrosis. H&E stain. Autopsy specimen.

ILD may be classified according to the cause.^[3] One method of classification is as follows: (Mnemonic- Inhaled Drugs Can Infect Idiopathic Malignancy)

Inhaled substances
- Inorganic
  - Silicosis
  - Asbestosis
  - Berylliosis
- Organic
  - Hypersensitivity pneumonitis
Drug induced
- Antibiotics
- Chemotherapeutic drugs
- Antiarrhythmic agents
- Statins
Connective tissue disease
- Systemic sclerosis
- Polymyositis
- Dermatomyositis
- Systemic lupus erythematosus
- Rheumatoid arthritis
Infection (mnemonic- TB is CRAP)
- Atypical pneumonia
- Pneumocystis pneumonia (PCP)
- Tuberculosis
- Chlamydia trachomatis
- Respiratory Syncytial Virus
Idiopathic
- Sarcoidosis
- Idiopathic pulmonary fibrosis
- Hamman-Rich syndrome
- Antisynthetase syndrome
Malignancy
- Lymphangitic carcinomatosis

Investigation[edit]

Patients with pneumocystis pneumonia can present with interstitial lung disease, as seen in the reticular markings on this AP chest x-ray

A chest X-ray demonstrating pulmonary fibrosis due to amiodarone.

Investigation is tailored towards the symptoms and signs. Most patients have blood testing, chest x-ray, pulmonary function testing, and high resolution CT thorax. HRCT thorax is the best mode of investigation to diagnose interstitial lung disease.

A lung biopsy is required if the clinical history and imaging are not clearly suggestive of a specific diagnosis or malignancy cannot otherwise be ruled out.

DLCO will be decreased in these patients.

Treatment[edit]

ILD is not a single disease, but encompasses many different pathological processes. Hence treatment is different for each disease.

If a specific occupational exposure cause is found, the person should avoid that environment. If a drug cause is suspected, that drug should be discontinued.

Many idiopathic and connective tissue-based causes of ILD are treated with corticosteroids,^[4] such as prednisolone. Some patients respond to immunosuppressant treatment. Patients with hypoxemia may be given supplemental oxygen.

References[edit]

^ King TE (August 2005). "Clinical advances in the diagnosis and therapy of the interstitial lung diseases". Am. J. Respir. Crit. Care Med. 172 (3): 268–79. doi:10.1164/rccm.200503-483OE. PMID 15879420. Cite uses deprecated parameters (help)
^ "Frequently Asked Questions About Interstitial Lung Disease - University of Chicago Medical Center".
^ Bourke SJ (August 2006). "Interstitial lung disease: progress and problems". Postgrad Med J 82 (970): 494–9. doi:10.1136/pgmj.2006.046417. PMC 2585700. PMID 16891438. Cite uses deprecated parameters (help)
^ "Interstitial lung disease: Treatments and drugs - MayoClinic.com".

External links[edit]

For more information and resources on ILD, please visit the UCSF ILD Program website

AIMIP Onlus - Italian Interstitial Lung Diseases No-Profit Organization
00736 at CHORUS
1476788304 at GPnotebook
Pulmonary Fibrosis at the US National Library of Medicine Medical Subject Headings (MeSH)
MedlinePlus Overview pulmonaryfibrosis
coalitionforpf.org - Coalition for Pulmonary Fibrosis: Pulmonary Fibrosis Patient Services, Education; Funding Research to Find a Cure for PF
GeneReview/NCBI/NIH/UW entry on Pulmonary Fibrosis, Familial
UCSF Interstitial Lung Disease Program at University of California San Francisco
Interstitial Lung Disease Program at University of Chicago Medical Center
Interstitial Lung Disease Center at University of Cincinnati
PA-IPF - The Pennsylvania Idiopathic Pulmonary Fibrosis State Registry at University of Pittsburgh
WASOG - World Association for Sarcoidosis and Other Granulomatous Disorders

UpToDate Contents

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1. 間質性肺疾患を有する成人に対するアプローチ：臨床的評価 approach to the adult with interstitial lung disease clinical evaluation
2. 間質性肺疾患を有する成人に対するアプローチ：診断的検査 approach to the adult with interstitial lung disease diagnostic testing
3. 非特異的間質性肺炎 nonspecific interstitial pneumonia
4. 間質性肺疾患を有する幼児および小児に対するアプローチ approach to the infant and child with interstitial lung disease
5. 特発性間質性肺炎：臨床症状および病理 idiopathic interstitial pneumonias clinical manifestations and pathology

English Journal

Immune-mediated respiratory adverse events of checkpoint inhibitors.

Tabchi S1, Messier C, Blais N.
Current opinion in oncology.Curr Opin Oncol.2016 Jul;28(4):269-77. doi: 10.1097/CCO.0000000000000291.
PURPOSE OF REVIEW: Immune checkpoint inhibitors have demonstrated remarkable efficacy with durable responses in the treatment of various malignancies. This new class of therapeutic agents is associated with a toxicity profile that differs from conventional cytotoxic therapy. The present review is fo
PMID 27138570

Positive fungal quantitative PCR and Th17 cytokine detection in bronchoalveolar lavage fluids: Complementary biomarkers of hypersensitivity pneumonitis?

Bellanger AP1, Gbaguidi-Haore H2, Gondoin A3, Pallandre JR4, Vacheyrou M5, Valot B5, Soumagne T3, Reboux G6, Dalphin JC3, Millon L6.
Journal of immunological methods.J Immunol Methods.2016 Jul;434:61-5. doi: 10.1016/j.jim.2016.04.008. Epub 2016 Apr 17.
BACKGROUND: Interstitial lung disease (ILD) is a large group of diseases, including hypersensitivity pneumonitis (HP), idiopathic pulmonary fibrosis (IPF) and sarcoidosis.OBJECTIVE: In this study, we aimed to identify bronchoalveolar lavage fluid (BALF) biomarkers which could be contributive for HP
PMID 27098083

Cardiac telocytes in normal and diseased hearts.

Kostin S1.
Seminars in cell & developmental biology.Semin Cell Dev Biol.2016 Jul;55:22-30. doi: 10.1016/j.semcdb.2016.02.023. Epub 2016 Feb 18.
Our previous studies suggested that an important variable of the progression of contractile dysfunction to terminal heart failure is the imbalance between myocyte cell death and myocyte renewal. For this reason, preventing myocyte cell death and an increasing generation of new myocytes may represent
PMID 26912117

Japanese Journal

全身性エリテマトーデス(SLE) (特集膠原病に合併する呼吸器疾患)

呼吸器内科 27(4), 269-275, 2015-04
NAID 40020447199

間質性肺炎 : その他(膠原病を除く) : 過敏性肺炎などの間質性肺炎についての報告の整理 (特集ステロイド薬(含吸入薬)の基礎と呼吸器疾患への臨床応用)

日本胸部臨床 74(4), 426-437, 2015-04
NAID 40020423390

症例慢性過敏性肺炎が疑われた症例の経過中に顕微鏡的多発血管炎を発症した1例

日本呼吸器学会誌 = Annals of the Japanese Respiratory Society 4(2), 189-193, 2015-03-10
NAID 40020410560

Related Pictures

★リンクテーブル★

リンク元	「間質性肺炎」「IP」「間質性肺臓炎」
拡張検索	「acute interstitial pneumonitis」
関連記事	「interstitial」

「間質性肺炎」

Interstitial lung disease
	Classification and external resources
	; End-stage pulmonary fibrosis of unknown origin, taken from an autopsy in the 1980s.
ICD-10	J84.9
ICD-9	506.4, 508.1, 515, 516.3, 714.81, 770.7

　　[★]

英: interstitial pneumonitis, interstitial lung disease, pneumonitis, interstitial pneumonia
同: びまん性間質性肺炎 diffuse interstitial pneumonia、びまん性線維性肺胞炎 diffuse fibrosisalveolitis、肺臓炎 pneumonitis
関: 肺炎、間質性肺疾患