Idiopathic interstitial pneumonia differential diagnosis: Difference between revisions

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==Overview==
Careful and extensive investigations in multiple visits to ensure the idiopathic interstitial pneumonia is accurately diagnosed. :*10 to 20% of patients with IPF have positive rheumatoid factor or positive circulating anti-nuclear antibodies (ANAs), but rarely are titers high. However only the presence of high titers (> 1:160) would suggest the presence of a connective tissue disease . <ref name="Scadding-1967">{{Cite journal | last1 = Scadding | first1 = JG. | last2 = Hinson | first2 = KF. | title = Diffuse fibrosing alveolitis (diffuse interstitial fibrosis of the lungs). Correlation of histology at biopsy with prognosis. | journal = Thorax | volume = 22 | issue = 4 | pages = 291-304 | month = Jul | year = 1967 | doi = | PMID = 6035793 }}</ref> <ref name="Nagaya-1969">{{Cite journal | last1 = Nagaya | first1 = H. | last2 = Buckley | first2 = CE. | last3 = Sieker | first3 = HO. | title = Positive antinuclear factor in patients with unexplained pulmonary fibrosis. | journal = Ann Intern Med | volume = 70 | issue = 6 | pages = 1135-45 | month = Jun | year = 1969 | doi = | PMID = 4892605 }}</ref> <ref name="Nagaya-1972">{{Cite journal | last1 = Nagaya | first1 = H. | last2 = Sieker | first2 = HO. |title = Pathogenetic mechanisms of interstitial pulmonary fibrosis in patients with serum antinuclear factor. A histologic and clinical correlation. |journal = Am J Med | volume = 52 | issue = 1 | pages = 51-62 | month = Jan | year = 1972 | doi = | PMID = 4536709 }}</ref>*


==Differential diagnosis==
==Differential Diagnosis==
 
* [[Sarcoidosis]]
* [[Sarcoidosis]]
* [[Hypersensitivity pneumonitis]]
* [[Hypersensitivity pneumonitis]]
Hypersensitivity pneumonia is always confusing a hypersensitivity pneumonitis especially if the triggering factor or the environmental exposure can be identified.
* [[Collagen vascular disease]]
* [[Collagen vascular disease]]
 
* [[Human immunodeficiency virus]], NSIP is commonly occuring in patients who have AIDS.<ref name="Suffredini-1987">{{Cite journal | last1 = Suffredini | first1 = AF. | last2 = Ognibene | first2 = FP. | last3 = Lack | first3 = EE. | last4 = Simmons | first4 = JT. | last5 = Brenner | first5 = M. | last6 = Gill | first6 = VJ. | last7 = Lane | first7 = HC. | last8 = Fauci | first8 = AS. | last9 = Parrillo | first9 = JE. | title = Nonspecific interstitial pneumonitis: a common cause of pulmonary disease in the acquired immunodeficiency syndrome. | journal = Ann Intern Med | volume = 107 | issue = 1 | pages = 7-13 | month = Jul | year = 1987 | doi = | PMID = 3496030 }}</ref><ref name="Simmons-1987">{{Cite journal | last1 = Simmons | first1 = JT. | last2 = Suffredini | first2 = AF. | last3 = Lack | first3 = EE. | last4 = Brenner | first4 = M. | last5 = Ognibene | first5 = FP. | last6 = Shelhamer | first6 = JH. | last7 = Lane | first7 = HC. | last8 = Fauci | first8 = AS. | last9 = Masur | first9 = H. | title = Nonspecific interstitial pneumonitis in patients with AIDS: radiologic features. | journal = AJR Am J Roentgenol | volume = 149 | issue = 2 | pages = 265-8 | month = Aug | year = 1987 | doi = 10.2214/ajr.149.2.265 | PMID = 3496748 }}</ref><ref name="Sattler-1997">{{Cite journal | last1 = Sattler | first1 = F. | last2 = Nichols | first2 = L. | last3 = Hirano | first3 = L. | last4 = Hiti | first4 = A. | last5 = Hofman | first5 = F. | last6 = Hughlett | first6 = C. | last7 = Zeng | first7 = L. | last8 = Boylen | first8 = CT. | last9 = Koss | first9 = M. | title = Nonspecific interstitial pneumonitis mimicking Pneumocystis carinii pneumonia. | journal = Am J Respir Crit Care Med | volume = 156 | issue = 3 Pt 1 | pages = 912-7 | month = Sep | year = 1997 | doi = 10.1164/ajrccm.156.3.9612050 | PMID = 9310013 }}</ref><ref name="Travis-1992">{{Cite journal | last1 = Travis | first1 = WD. | last2 = Fox | first2 = CH. | last3 = Devaney | first3 = KO. | last4 = Weiss | first4 = LM. | last5 = O'Leary | first5 = TJ. | last6 = Ognibene | first6 = FP. | last7 = Suffredini | first7 = AF. | last8 = Rosen | first8 = MJ. | last9 = Cohen | first9 = MB. | title = Lymphoid pneumonitis in 50 adult patients infected with the human immunodeficiency virus: lymphocytic interstitial pneumonitis versus nonspecific interstitial pneumonitis. | journal = Hum Pathol | volume = 23 | issue = 5 | pages = 529-41 | month = May | year = 1992 | doi = | PMID = 1314778 }}</ref><ref name="Griffiths-1995">{{Cite journal | last1 = Griffiths | first1 = MH. | last2 = Miller | first2 = RF. | last3 = Semple | first3 = SJ. | title = Interstitial pneumonitis in patients infected with the human immunodeficiency virus. | journal = Thorax | volume = 50 | issue = 11 | pages = 1141-6 | month = Nov | year = 1995 | doi = | PMID = 8553268 }}</ref>
Extensive serological evaluation is needed to rule out collagen diseases <ref name="Raghu-2011">{{Cite journal | last1 = Raghu | first1 = G. | last2 = Collard | first2 = HR. | last3 = Egan | first3 = JJ. | last4 = Martinez | first4 = FJ. | last5 = Behr | first5 = J. | last6 = Brown | first6 = KK. | last7 = Colby | first7 = TV. | last8 = Cordier | first8 = JF. | last9 = Flaherty | first9 = KR. | title = An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. | journal = Am J Respir Crit Care Med | volume = 183 | issue = 6 | pages = 788-824 | month = Mar | year = 2011 | doi = 10.1164/rccm.2009-040GL | PMID = 21471066 }}</ref>. The clinical, serologic, HRCT, and histolpathological findings may be helpful in distinguishing IIPs from ILD associated with collagen vascular disease CVDs. <ref name="Felício-">{{Cite journal | last1 = Felício | first1 = CH. | last2 = Parra | first2 = ER. | last3 = Capelozzi | first3 = VL. | title = Idiopathic and collagen vascular disease nonspecific interstitial pneumonia: clinical significance of remodeling process. | journal = Lung | volume = 185 | issue = 1 | pages = 39-46 | month = | year = | doi = 10.1007/s00408-006-0104-2 | PMID = 17294340 }}</ref> <ref name="Park-2007">{{Cite journal | last1 = Park | first1 = JH. | last2 = Kim | first2 = DS. | last3 = Park | first3 = IN. | last4 = Jang | first4 = SJ. | last5 = Kitaichi | first5 = M. | last6 = Nicholson | first6 = AG. | last7 = Colby | first7 = TV. | title = Prognosis of fibrotic interstitial pneumonia: idiopathic versus collagen vascular disease-related subtypes. | journal = Am J Respir Crit Care Med | volume = 175 | issue = 7 | pages = 705-11 | month = Apr | year = 2007 | doi = 10.1164/rccm.200607-912OC | PMID = 17218621 }}</ref> <ref name="Hwang-">{{Cite journal | last1 = Hwang | first1 = JH. | last2 = Misumi | first2 = S. | last3 = Sahin | first3 = H. | last4 = Brown | first4 = KK. | last5 = Newell | first5 = JD. | last6 = Lynch | first6 = DA. | title = Computed tomographic features of idiopathic fibrosing interstitial pneumonia: comparison with pulmonary fibrosis related to collagen vascular disease. | journal = J Comput Assist Tomogr | volume = 33 | issue = 3 | pages = 410-5 | month = | year = | doi = 10.1097/RCT.0b013e318181d551 | PMID = 19478636 }}</ref> <ref name="Song-2009">{{Cite journal | last1 = Song | first1 = JW. | last2 = Do | first2 = KH. | last3 = Kim | first3 = MY. | last4 = Jang | first4 = SJ. | last5 = Colby | first5 = TV. | last6 = Kim | first6 = DS. | title = Pathologic and radiologic differences between idiopathic and collagen vascular disease-related usual interstitial pneumonia. | journal = Chest | volume = 136 | issue = 1 | pages = 23-30 | month = Jul | year = 2009 | doi = 10.1378/chest.08-2572 | PMID = 19255290 }}</ref>. However a significant number of patients have overlapping serological findings, yet they do not meet the fully defined criteria for CVDs and still are categorized as IIPs.
 
* [[Human immunodeficiency virus]]
 
* [[Antiphospholipid antibody syndrome]]
* [[Antiphospholipid antibody syndrome]]
* [[Chronic obstructive pulmonary disease]]
* [[Chronic obstructive pulmonary disease]]
* [[Coalworker's pneumoconiosis]]
* [[Coalworker's pneumoconiosis]]
* [[Drug induced pulmonary toxicity]]
* [[Drug induced pulmonary toxicity]]
* [[Lymphocytic interstitial pneumonia]]
* [[Lymphocytic interstitial pneumonia]]
* [[Idiopathic pulmonary fibrosis]]
* [[Idiopathic pulmonary fibrosis]]
 
* [[Diaphragmatic paralysis]]
* [[Diaphragmatic Paralysis]]
 
* [[Primary pulmonary hypertension]]
* [[Primary pulmonary hypertension]]
* [[Restrictive lung disease]]
* [[Restrictive lung disease]]
* [[Silicosis]]
* [[Silicosis]]


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
{{WH}}
{{WS}}
 


[[Category:Pulmonology]]
[[Category:Pulmonology]]
[[Category:Disease]]
[[Category:Disease]]
{{WH}}
{{WS}}

Latest revision as of 15:29, 21 November 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]

Overview

Careful and extensive investigations in multiple visits to ensure the idiopathic interstitial pneumonia is accurately diagnosed. :*10 to 20% of patients with IPF have positive rheumatoid factor or positive circulating anti-nuclear antibodies (ANAs), but rarely are titers high. However only the presence of high titers (> 1:160) would suggest the presence of a connective tissue disease . [1] [2] [3]*

Differential Diagnosis

References

  1. ↑ Scadding, JG.; Hinson, KF. (1967). "Diffuse fibrosing alveolitis (diffuse interstitial fibrosis of the lungs). Correlation of histology at biopsy with prognosis". Thorax. 22 (4): 291–304. PMID 6035793. Unknown parameter |month= ignored (help)
  2. ↑ Nagaya, H.; Buckley, CE.; Sieker, HO. (1969). "Positive antinuclear factor in patients with unexplained pulmonary fibrosis". Ann Intern Med. 70 (6): 1135–45. PMID 4892605. Unknown parameter |month= ignored (help)
  3. ↑ Nagaya, H.; Sieker, HO. (1972). "Pathogenetic mechanisms of interstitial pulmonary fibrosis in patients with serum antinuclear factor. A histologic and clinical correlation". Am J Med. 52 (1): 51–62. PMID 4536709. Unknown parameter |month= ignored (help)
  4. ↑ Suffredini, AF.; Ognibene, FP.; Lack, EE.; Simmons, JT.; Brenner, M.; Gill, VJ.; Lane, HC.; Fauci, AS.; Parrillo, JE. (1987). "Nonspecific interstitial pneumonitis: a common cause of pulmonary disease in the acquired immunodeficiency syndrome". Ann Intern Med. 107 (1): 7–13. PMID 3496030. Unknown parameter |month= ignored (help)
  5. ↑ Simmons, JT.; Suffredini, AF.; Lack, EE.; Brenner, M.; Ognibene, FP.; Shelhamer, JH.; Lane, HC.; Fauci, AS.; Masur, H. (1987). "Nonspecific interstitial pneumonitis in patients with AIDS: radiologic features". AJR Am J Roentgenol. 149 (2): 265–8. doi:10.2214/ajr.149.2.265. PMID 3496748. Unknown parameter |month= ignored (help)
  6. ↑ Sattler, F.; Nichols, L.; Hirano, L.; Hiti, A.; Hofman, F.; Hughlett, C.; Zeng, L.; Boylen, CT.; Koss, M. (1997). "Nonspecific interstitial pneumonitis mimicking Pneumocystis carinii pneumonia". Am J Respir Crit Care Med. 156 (3 Pt 1): 912–7. doi:10.1164/ajrccm.156.3.9612050. PMID 9310013. Unknown parameter |month= ignored (help)
  7. ↑ Travis, WD.; Fox, CH.; Devaney, KO.; Weiss, LM.; O'Leary, TJ.; Ognibene, FP.; Suffredini, AF.; Rosen, MJ.; Cohen, MB. (1992). "Lymphoid pneumonitis in 50 adult patients infected with the human immunodeficiency virus: lymphocytic interstitial pneumonitis versus nonspecific interstitial pneumonitis". Hum Pathol. 23 (5): 529–41. PMID 1314778. Unknown parameter |month= ignored (help)
  8. ↑ Griffiths, MH.; Miller, RF.; Semple, SJ. (1995). "Interstitial pneumonitis in patients infected with the human immunodeficiency virus". Thorax. 50 (11): 1141–6. PMID 8553268. Unknown parameter |month= ignored (help)

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