The Drug-Induced Respiratory Disease Website
(Fr: fibrose pulmonaire). The background incidence of idiopathic pulmonary fibrosis (IPF) has to be taken into account for causality assessment. Imaging at PMID 23672718. The diagnosis of interstitial pulmonary fibrosis�is raised in the presence of linear pulmonary opacities and architectural distortion on imaging incl. HRCT, restrictive lung dysfunction, low KCO, and hypoxemia obviating the need for a lung biopsy. Presentation can be chronic, subacute or rapidly progressive. Generally, the condition develops insidiously with dyspnea and bibasilar or diffuse reticular or streaky opacities. Honeycombing can develop with time in longterm survivors. DI-fibrosis may follow a classic episode of chemotherapy- or amiodarone-induced pulmonary toxicity. Separation of DI-fibrosis from idiopathic or CTD (viz. RA or scleroderma)-related fibrosis can be arduous (PMID 23791462).�Patients may exacerbate and progress to ARDS. DI-fibrosis may develop late after completion of therapy with chemo agents, irradiation or amiodarone with no evidence of toxicity during treatment or in the meantime. DI-fibrosis rarely occurs as a complication of patterns Ia, b or c. Oxygen and irradiation can trigger the onset of or exacerbate DI-fibrosis. When DI-fibrosis develops during treatment with the offending agent, drug withdrawal may translate into some improvement. Costicosteroid therapy is indicated, but the results are unpredictable
Publications
Tobacco smoking and risk for pulmonary fibrosis: A prospective cohort study in UK Biobank.
Chest 2021 Apr 24;; — 2021 Apr 24
Abramson MJ, Murambadoro T, Alif SM, Benke GP, Dharmage SC, Glaspole I, Hopkins P, Hoy RF, Klebe S, Moodley Y, Rawson S, Reynolds PN, Wolfe R, Corte TJ, Walters EH,
Occupational and environmental risk factors for idiopathic pulmonary fibrosis in Australia: case-control study.
Thorax 2020 Oct;75;864-869 — 2020 Oct — 864-869
Tobacco smoke-induced lung fibrosis and emphysema.
Annual review of physiology 2014;76;493-513 — 2014 — 493-513
Smoking-related interstitial fibrosis (SRIF): pathologic findings and distinction from other chronic fibrosing lung diseases.
Journal of clinical pathology 2013 Oct;66;882-7 — 2013 Oct — 882-7
Smoking-related interstitial lung diseases.
Clinics in chest medicine 2012 Mar;33;165-78 — 2012 Mar — 165-78
Challenges in pulmonary fibrosis . 4: smoking-induced diffuse interstitial lung diseases.
Thorax 2007 Oct;62;904-10 — 2007 Oct — 904-10
Cigarette smoking: a risk factor for idiopathic pulmonary fibrosis.
American journal of respiratory and critical care medicine 1997 Jan;155;242-8 — 1997 Jan — 242-8