Idiopathic interstitial pneumonia

• Characterised by pathological evidence of usual interstitial pneumonia (UIP)
• M>F, onset around 50
• Present with cough and dyspnoea
• Fine end inspiratory crackles at the lung bases (like unzipping Velcro)
• RHF
• Around 3 year survival

2 – Non-specific interstitial pneumonia

• M=F, presents around 40
• Split into three types, 1 – associated predominantly with inflammation, 2 – associated with a mix of inflammation and fibrosis and 3 – predominantly fibrosis
• Not associated with smoking

3 – Cryptogenic organising pneumonia

• More common in non-smokers
• Short preceding illness, generally follows what seems like and URT
• Cough and dyspnoea
• Associated with increased CRP and inflammatory markers
• Give steroids – risk of relapse

4 – Acute

• Histologically looks like ARDS
• M=F, age 50ish, not associated with smoking
• Associated with prior illness such as URTI
• 50% mortality
• Histologically associated with hyaline membranes

5 – Bronchiolitis associated interstitial pneumonia

• Associated with smoking
• Occurs more commonly in men age 40 – 50
• Improves with smoking cessation
• Not associated with clubbing

6 – Desquamative

• Considered a form of bronchiolitis associated interstitial pneumonia that is more diffuse
• Associated with intra-alveolar macrophage accumulation
• Associated with clubbing
• Good prognosis with smoking cessation and steroids

7 – Lymphoid interstitial

• May be pre-neoplastic to lymphoma
• F>M, age around 50
• Associated with autoimmune diseases
• Treat with steroids