Acute exacerbations of interstitial lung diseases

作者：Papanikolaou Ilias C^*; Drakopanagiotakis Fotios; Polychronopoulos Vlasis S

来源：Current Opinion in Pulmonary Medicine, 2010, 16(5): 480-486.

DOI：10.1097/MCP.0b013e32833ae49d

• acute exacerbation
• collagen vascular diseases
• hypersensitivity pneumonitis
• idiopathic pulmonary fibrosis
• interstitial lung diseases

Purpose of review
This review aims to highlight recent advances in pathogenesis, clinical presentation and treatment of interstitial lung diseases (ILDs).
Recent findings
Acute exacerbation is increasingly recognized as a major complication in the course of idiopathic pulmonary fibrosis. It is precipitated by a variety of intrinsic and extrinsic factors. Moreover, acute exacerbation is an apparently equally frequent event in hypersensitivity pneumonitis and collagen-vascular diseases associated ILDs, especially the rheumatoid pulmonary fibrosis. Treatment of acute exacerbations is unsatisfactory and prognosis extremely poor.
Summary
In a critically ill patient proper recognition of an acute exacerbation and of the underlying chronic ILD is warranted because treatment approach varies with the type of ILD. Advances in the understanding of the pathogenesis and treatment of this 'idiopathic' phenomenon are reviewed.

• 出版日期2010-9