Interstitial (Nonidiopathic) Pulmonary Fibrosis Follow-up

  • Author: Eleanor M Summerhill, MD, FACP, FCCP; Chief Editor: Zab Mosenifar, MD   more...
 
Updated: Jun 13, 2011
 

Further Inpatient Care

  • Patients with interstitial lung disease generally are treated in an outpatient setting.
  • With advancing disease, progressive respiratory failure, pneumonia, pulmonary embolism, and cor pulmonale may all occur and require hospital admission.
  • Bronchogenic cancer occurs with increased frequency.[17]
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Further Outpatient Care

  • See patients with diffuse interstitial lung disease every 3-6 months.
    • Order pulmonary function testing every 3-6 months to assess disease progression and response to therapy.
    • High-resolution CT scanning is becoming an increasingly important tool in making the initial diagnosis and subsequent assessments of disease progression and/or responses to therapy.
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Inpatient & Outpatient Medications

  • Immunosuppressive and antifibrotic medications and supplemental oxygen may be indicated for some patients.
  • Prompt treatment is necessary for complicating pulmonary disease such as cor pulmonale (oxygen, diuretics), pulmonary embolism (anticoagulants), and infection (antibiotics).
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Transfer

  • Most patients with DPLD can be treated in community settings.
  • Transfer to a tertiary care center is indicated when the diagnosis is in doubt or when treatment is ineffective.
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Deterrence/Prevention

  • Prevention is predicated upon the specific diagnosis.
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Complications

  • Progressive respiratory failure
  • Cor pulmonale
  • Pulmonary embolism
  • Pneumothorax
  • Pneumonia
  • Bronchogenic carcinoma
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Prognosis

  • The prognosis is variable and depends on the specific diagnosis and clinical, physiologic, and pathologic severity.
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Patient Education

  • Educate patients about the nature of the specific diagnosis and about potential toxicities of prescribed medications.
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Contributor Information and Disclosures
Author

Eleanor M Summerhill, MD, FACP, FCCP  Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Warren Alpert Medical School of Brown University; Director, Internal Medicine Residency Program, Memorial Hospital of Rhode Island

Eleanor M Summerhill, MD, FACP, FCCP is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Thoracic Society, Association of Program Directors in Internal Medicine, and Rhode Island Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP  Professor of Genomics and Personalized Medicine Research, Internal Medicine, and Pediatrics, Associate Director, Center for Genomics and Personalized Medicine Research, Director of Research, Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases, Wake Forest University School of Medicine

Stephen P Peters, MD, PhD, FACP, FAAAAI, FCCP, FCPP is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Association of Immunologists, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Thoracic Society, and Sigma Xi

Disclosure: See below for list of all activities None None

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Daniel R Ouellette, MD, FCCP  Associate Professor of Medicine, Wayne State University School of Medicine; Consulting Staff, Pulmonary Disease and Critical Care Medicine Service, Henry Ford Health System

Daniel R Ouellette, MD, FCCP is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society

Disclosure: Boehringer Ingleheim Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching; Astra Zeneca Honoraria Speaking and teaching

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD  Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Robert S. Crausman, MD, MMS, to the development and writing of this article.

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Frontal chest radiograph demonstrating bilateral reticular and nodular interstitial infiltrates with upper zone predominance.
High-resolution chest CT scan of patient with bilateral reticular and nodular interstitial infiltrates with upper zone predominance.
 
 
 
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