Approach to the patient with diffuse lung disease

P. E. Krumpe, C. C Q Lum, Carroll E Cross

Research output: Contribution to journalArticle

Abstract

When evaluating diffuse lung infiltrates, the clinician should place special emphasis on the acuity of symptoms, nonpulmonary complaints and findings, environmental exposures, and risk factors for immunosuppressive diseases. Certain radiographic features, such as the distribution of opacities, hilar adenopathy, Kerley-B lines or pneumothorax, or pulmonary function tests demonstrating air flow limitation also narrow the differential diagnosis. One can direct the subsequent workup based on the narrowed differential diagnosis, the pace of disease, the activity of the ongoing inflammatory-immune process, and the age, overall medical condition, and wishes of the patient. Unless a specific diagnosis (for example, hypersensitivity pneumonitis, the treatment of which is withdrawal of the offending agent) can be made, therapy of noninfectious diffuse lung disease is quite unsatisfactory. Immunosuppressive therapy is indicated to arrest the active inflammatory process with the hope that objective signs of improvement will occur after a 3- to 12-month course. Important areas of basic research in pulmonary fibrosis include cell-cell and cell-matrix interactions in the lung interstitium and delineation of fibroblast biology and cytokine-mediated lung connective tissue pathology. More successful therapies will probably evolve from better understanding of the molecular and cellular biology of the lung fibrogenic process.

Original languageEnglish (US)
Pages (from-to)1225-1246
Number of pages22
JournalMedical Clinics of North America
Volume72
Issue number5
StatePublished - 1988

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Lung Diseases
Lung
Immunosuppressive Agents
Differential Diagnosis
Extrinsic Allergic Alveolitis
Pulmonary Fibrosis
Respiratory Function Tests
Environmental Exposure
Pneumothorax
Therapeutics
Cell Communication
Connective Tissue
Cell Biology
Molecular Biology
Fibroblasts
Air
Pathology
Cytokines
Research

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Approach to the patient with diffuse lung disease. / Krumpe, P. E.; Lum, C. C Q; Cross, Carroll E.

In: Medical Clinics of North America, Vol. 72, No. 5, 1988, p. 1225-1246.

Research output: Contribution to journalArticle

Krumpe, PE, Lum, CCQ & Cross, CE 1988, 'Approach to the patient with diffuse lung disease', Medical Clinics of North America, vol. 72, no. 5, pp. 1225-1246.
Krumpe, P. E. ; Lum, C. C Q ; Cross, Carroll E. / Approach to the patient with diffuse lung disease. In: Medical Clinics of North America. 1988 ; Vol. 72, No. 5. pp. 1225-1246.
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