ILD Differentials
I always teach the importance of a good differential.
When it comes to Pulmonary Medicine, what better than interstitial lung disease to really make you think?
Diagnosing ILD can be extremely challenging for the clinician yet exceptionally important for the patient’s care.
The diagnostic process requires detailed history-taking, reliable and recent CT chest imaging (occasionally needing high resolution CT or HRCT), pulmonary function testing, and/or multidisciplinary meetings of pulmonologists, radiology, and/or pathology, if lung biopsy is taken.
With an ever-increasing emphasis on less invasive diagnostic approaches, precise pattern recognize becomes more vital for timely diagnosis.
Don’t forget to review my patient history-taking approach to ILD on the Pulmonary Rotation Page
Start the Q n A process here. Let’s begin.
Name 4 DDx for Pneumoconioses 👩🏭
- Berylliosis
- Silicosis
- Asbestosis
- Coal workers (CWP)
Name 4 (or 5) 🖐️Connective Tissue / Collagen Vascular Disease- ILDs 👉
- Systemic sclerosis-related ILD (SSc-ILD, Scleroderma)
- Primary Sjögren’s disease
- Polymyositis/Dermatomyositis
- Rheumatoid Arthritis (RA-ILD)
- Idiopathic inflammatory myopathy
Name 3 DDx for 🚬Smoking-Related ILD 👉
- Respiratory Bronchiolitis(RB-ILD)
- Desquamative Interstitial Pneumonitis (DIP)
- Pulmonary Langerhans Cell Histiocytosis (PLCH)
Name 8 DDx for Rare Cystic ILDs 👉
- Lymphangioleiomyomatosis (LAM)
- Lymphocytic Interstitial Pneumonitis (LIP)
- Burt-Hogg-Dubé Syndrome
- Amyloidosis / Light Chain Deposition Disease
- Pulmonary Langerhans Cell Histiocytosis (PLCH)
- Pneumocystis jiroveci pneumonia (PJP, formerly Pneumocystis carinii)
- Desquamative Interstitial Pneumonitis (DIP)
- Congenital Cystic Lung (Cystic fibrosis, CPAM)
Excellent review article from CHEST on Diffuse Cystic Lung Disease 👇
Name 2 Eosinophilic DDx of ILDs 👉
- EGPA
- Acute / Chronic Eosinophilic Pneumonias
Name 4 DDx for Granulomatous ILD 👉
- Hypersensitivity pneumonitis (HP)
- Sarcoidosis
- EGPA
- GPA
Name 7 Idiopathic Interstitial Pneumonias 👉
- Acute interstitial pneumonitis (AIP or Hamman-Rich Syndrome)
- Cryptogenic Organizing Pneumonia (COP)
- Idiopathic Pulmonary Fibrosis (UIP/IPF)
- Nonspecific Interstitial Pneumonitis (NSIP)
- Lymphocytic Interstitial Pneumonitis (LIP)
- Smoking-Related (RB-ILD, DIP)
- Pleuroparenchymal Fibroelastosis
Name 2 DDx for Environmental-associated ILDs 👉
- Hypersensitivity pneumonitis (HP)
- Pneumoconioses
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