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[药物性间质性肺疾病:常被遗忘]

[Drug-induced interstitial lung diseases: often forgotten].

作者信息

Poschenrieder F, Stroszczynski C, Hamer O W

机构信息

Institut für Röntgendiagnostik, Universitätsklinikum Regensburg, Franz-Josef-Strauß-Alle 11, 93053, Regensburg, Deutschland,

出版信息

Radiologe. 2014 Dec;54(12):1180-8. doi: 10.1007/s00117-014-2737-0.

Abstract

Drug-induced interstitial lung diseases (DILD) are probably more common than diagnosed. Due to their potential reversibility, increased vigilance towards DILD is appropriate also from the radiologist's point of view, particularly as these diseases regularly exhibit radiological correlates in high-resolution computed tomography (HRCT) of the lungs.Based on personal experience typical relatively common manifestations of DILD are diffuse alveolar damage (DAD), eosinophilic pneumonia (EP), hypersensitivity pneumonitis (HP), organizing pneumonia (OP), non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). These patterns are presented based on case studies, whereby emphasis is placed on the clinical context. This is to highlight the relevance of interdisciplinary communication and discussion in the diagnostic field of DILD as it is a diagnosis of exclusion or of probability in most cases.Helpful differential diagnostic indications for the presence of DILD, such as an accompanying eosinophilia or increased attenuation of pulmonary consolidations in amiodarone-induced pneumopathy are mentioned and the freely available online database http://www.pneumotox.com is presented.

摘要

药物性间质性肺疾病(DILD)可能比已诊断出的更为常见。鉴于其潜在的可逆性,从放射科医生的角度来看,提高对DILD的警惕性是合适的,特别是因为这些疾病在肺部高分辨率计算机断层扫描(HRCT)中经常表现出放射学相关性。根据个人经验,DILD典型的相对常见表现为弥漫性肺泡损伤(DAD)、嗜酸性粒细胞性肺炎(EP)、过敏性肺炎(HP)、机化性肺炎(OP)、非特异性间质性肺炎(NSIP)和寻常型间质性肺炎(UIP)。这些模式基于病例研究呈现,重点在于临床背景。这是为了突出在DILD诊断领域跨学科交流和讨论的相关性,因为在大多数情况下它是一种排除性或可能性诊断。文中提到了有助于诊断DILD的鉴别诊断指标,如在胺碘酮所致肺病中伴随的嗜酸性粒细胞增多或肺部实变的密度增加,并介绍了免费的在线数据库http://www.pneumotox.com

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