Pulmonary | Radiology | Treatment | |
---|---|---|---|
UIP | Older age | Subpleural | Anti fibrotic medications |
Male sex | Basilar predominant | Consider referral for lung transplant soon after diagnosis as course is unpredictable and inexorable | |
Smoking history | Honeycombing | Anti-inflammatory and immunosuppressive Rx NOT indicated (may be harmful) | |
Crackles at lung bases | |||
Clubbing | |||
NSIP | Younger age | Homogeneous | Anti-inflammatory medications |
Female sex | Bronchovascular | Consider referral for lung transplant if advanced disease | |
Connective tissue disease | Lower lobe | ||
Positive serologies | Dilated esophagus | ||
Peripheral sparring | |||
CHP | Older age | Peribronchiolar fibrosis | Anti-inflammatory medications |
Female | Air trapping | Removal of causative antigen | |
Bird owner | Upper lobe | Consider referral for lung transplant if advanced disease | |
Mold exposure | |||
S4 | Younger age | Upper lobe posterior | Anti-inflammatory medications |
Less symptomatic | Calcified lymph nodes | Consider transplantation for advanced disease (PHN, hypoxemia, declining PFT's) | |
Peribronchiolar fibrosis |
CHP, chronic hypersensitivity pneumonitis; NSIP, non-specific interstitial pneumonitis; S4, stage 4 sarcoidosis; PFT, Pulmonary Function Test; PHN, pulmonary hypertension; UIP, usual interstitial pneumonitis.