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Harrison's Principles of Internal Medicine, 18e
| Part 11. Disorders of the Respiratory System > Section 2. Diseases of the Respiratory System > |
Chapter 261. Interstitial Lung Diseases
Sections: Interstitial Lung Diseases: Introduction, Individual Forms of ILD, Further Readings.
Topics Discussed: interstitial lung diseases.
Excerpt:"Patients with interstitial lung diseases (ILDs) come to medical attention mainly because of the onset of progressive exertional dyspnea or a persistent nonproductive cough. Hemoptysis, wheezing, and chest pain may be present. Often, the identification of interstitial opacities on chest x-ray focuses the diagnostic approach on one of the ILDs.The ILDs are nonmalignant disorders and are not caused by identified infectious agents. The precise pathway(s) leading from injury to fibrosis is not known. Although there are multiple initiating agent(s) of injury, the immunopathogenic responses of lung tissue are limited, and the mechanisms of repair have common features (Fig. 261-1).This process is characterized by an accumulation of T lymphocytes, macrophages, and epithelioid cells organized into discrete structures (granulomas) in the lung parenchyma. The granulomatous lesions can progress to fibrosis. Many patients with granulomatous lung disease remain free of severe impairment of lung function or, when symptomatic, improve after treatment. The main differential diagnosis is between sarcoidosis (Chap. 329) and hypersensitivity pneumonitis (Chap. 255).Acute presentation (days to weeks), although unusual, occurs..."
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