Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease

Interstitial lung diseases (ILDs) are heterogeneous in their clinical presentation. Making a differential diagnosis of ILD requires a thorough medical history, clinical examination, serologies, high-resolution computed tomography (CT) scan, and, in some cases, bronchoalveolar lavage or surgical lung...

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Main Author: Leslie B. Tolle
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Pulmonology
Online Access:http://dx.doi.org/10.1155/2022/9942432
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author Leslie B. Tolle
author_facet Leslie B. Tolle
author_sort Leslie B. Tolle
collection DOAJ
description Interstitial lung diseases (ILDs) are heterogeneous in their clinical presentation. Making a differential diagnosis of ILD requires a thorough medical history, clinical examination, serologies, high-resolution computed tomography (CT) scan, and, in some cases, bronchoalveolar lavage or surgical lung biopsy. Multidisciplinary discussion is recommended to improve diagnostic confidence. ILDs have a variable and unpredictable clinical course. Patients should be closely monitored to ensure that progression of ILD is detected promptly. This involves regular assessment of symptoms, lung function, and, where appropriate, high-resolution CT. Patients with some fibrosing ILDs may respond well to immunosuppressants, but even patients who respond well to immunosuppressants initially may later show deterioration despite appropriate management. The tyrosine kinase inhibitor nintedanib has been approved for the treatment of idiopathic pulmonary fibrosis, other chronic fibrosing ILDs with a progressive phenotype, and systemic sclerosis-associated ILD. The three case studies described in this article illustrate the challenges in the diagnosis and management of patients with fibrosing ILDs and the importance of taking a multidisciplinary and individualized approach to care, including regular monitoring and consideration of whether a patient’s drug regimen needs to be changed when there is evidence of disease progression.
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spelling doaj-art-61ad3d67be3c4943a8500c4fb0b587db2025-02-03T06:11:17ZengWileyCase Reports in Pulmonology2090-68542022-01-01202210.1155/2022/9942432Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung DiseaseLeslie B. Tolle0Department of Pulmonary Medicine and Critical Care MedicineInterstitial lung diseases (ILDs) are heterogeneous in their clinical presentation. Making a differential diagnosis of ILD requires a thorough medical history, clinical examination, serologies, high-resolution computed tomography (CT) scan, and, in some cases, bronchoalveolar lavage or surgical lung biopsy. Multidisciplinary discussion is recommended to improve diagnostic confidence. ILDs have a variable and unpredictable clinical course. Patients should be closely monitored to ensure that progression of ILD is detected promptly. This involves regular assessment of symptoms, lung function, and, where appropriate, high-resolution CT. Patients with some fibrosing ILDs may respond well to immunosuppressants, but even patients who respond well to immunosuppressants initially may later show deterioration despite appropriate management. The tyrosine kinase inhibitor nintedanib has been approved for the treatment of idiopathic pulmonary fibrosis, other chronic fibrosing ILDs with a progressive phenotype, and systemic sclerosis-associated ILD. The three case studies described in this article illustrate the challenges in the diagnosis and management of patients with fibrosing ILDs and the importance of taking a multidisciplinary and individualized approach to care, including regular monitoring and consideration of whether a patient’s drug regimen needs to be changed when there is evidence of disease progression.http://dx.doi.org/10.1155/2022/9942432
spellingShingle Leslie B. Tolle
Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease
Case Reports in Pulmonology
title Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease
title_full Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease
title_fullStr Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease
title_full_unstemmed Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease
title_short Challenges in the Diagnosis and Management of Patients with Fibrosing Interstitial Lung Disease
title_sort challenges in the diagnosis and management of patients with fibrosing interstitial lung disease
url http://dx.doi.org/10.1155/2022/9942432
work_keys_str_mv AT lesliebtolle challengesinthediagnosisandmanagementofpatientswithfibrosinginterstitiallungdisease