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Diffuse Lung Disease: Classification and Evaluation

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Diffuse Lung Disease

Abstract

There are more than 200 clinical forms of diffuse lung disease (DLD) with a wide variety of causes and associations. The physician faced with a suspected case of DLD must therefore have an organized and systematic approach to the diagnostic evaluation. One such approach is to divide these processes into five broad clinical categories. These are: primary disease related, environmental exposure related, drug induced, collagen-vascular associated, and the idiopathic interstitial pneumonias. The history and physical examination is of critical importance in identifying possible exposures to occupational and environmental substances known to cause DLD, documenting drug exposures, and eliciting symptoms and signs of collagen-vascular disease or other primary diseases. Radiographic, physiologic, and laboratory evaluation can often confirm the presumptive diagnosis. Importantly, a minority of patients will have no identifiable cause of DLD after careful clinical evaluation. These patients are considered to have idiopathic DLD, termed idiopathic interstitial pneumonias. The current ATS/ERS classification schema for the idiopathic interstitial pneumonias includes seven distinct subgroups associated with distinctive histopathological patterns of injury and repair: idiopathic pulmonary fibrosis (IPF), nonspecific interstitial pneumonia, acute interstitial pneumonia, cryptogenic organizing pneumonia, lymphocytic interstitial pneumonia, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia.

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Authors and Affiliations

  1. Department of Medicine, University of California San Francisco, San Francisco, CA, USA

    Harold R. Collard MD & Talmadge E. King Jr. MD

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  1. Harold R. Collard MD
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  2. Talmadge E. King Jr. MD
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Correspondence to Talmadge E. King Jr. MD .

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Editors and Affiliations

  1. University of Cincinnati, College of Medicine, Department of Internal Medicine, Eden Ave, Cincinnati, 45267-0565, Ohio, USA

    Robert P. Baughman

  2. of Respiratory Medicine, Imperial College, Emeritus Professor, Grand Ave 14, London, N10 3BB, United Kingdom

    Roland M. du Bois

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Collard, H.R., King, T.E. (2012). Diffuse Lung Disease: Classification and Evaluation. In: Baughman, R., du Bois, R. (eds) Diffuse Lung Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-9771-5_6

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  • DOI: https://doi.org/10.1007/978-1-4419-9771-5_6

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4419-9770-8

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