Expired CME Article
A Clinician's Guide to the Diagnosis and Treatment of Interstitial Lung Diseases
Abstract
Interstitial lung disease (ILD) is a final common pathway for a large number of lung insults. It is characterized by progressive scarring of the lung leading to restriction and diminished oxygen transfer. Clinically, the presenting symptoms of ILD are nonspecific (cough and progressive dyspnea on exertion) and are often attributed to other diseases, thus delaying diagnosis and timely therapy. ILD occurs most commonly in older individuals and is increasingly encountered by internists. Both the diagnosis and treatment can be daunting: patients frequently have irreversibly impaired lung function at diagnosis, and therapeutic modalities are limited and associated with significant adverse effects. This review will assist internists in the recognition and management of ILD, provide a benchmark for pulmonary referrals, and offer guidance in advising patients with this life-threatening disorder.
Key Points
* Early recognition and diagnosis of interstitial lung disease is critical for optimal management.
* Recognition of interstitial lung disease by internists depends on identifying nonspecific symptoms in an appropriate clinical context and obtaining appropriate diagnostic studies.
* Optimal management of interstitial lung disease depends on the close collaboration between internists and pulmonologists to identify the etiology of the disease, select appropriate treatments and carefully monitor for objective response and side effects.
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