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Acute exacerbations of interstitial lung diseases

Papanikolaou, Ilias C; Drakopanagiotakis, Fotios; Polychronopoulos, Vlasis S

Current Opinion in Pulmonary Medicine: September 2010 - Volume 16 - Issue 5 - p 480–486
doi: 10.1097/MCP.0b013e32833ae49d
Sarcoidosis: Edited by Om P. Sharma

Purpose of review This review aims to highlight recent advances in pathogenesis, clinical presentation and treatment of interstitial lung diseases (ILDs).

Recent findings Acute exacerbation is increasingly recognized as a major complication in the course of idiopathic pulmonary fibrosis. It is precipitated by a variety of intrinsic and extrinsic factors. Moreover, acute exacerbation is an apparently equally frequent event in hypersensitivity pneumonitis and collagen–vascular diseases associated ILDs, especially the rheumatoid pulmonary fibrosis. Treatment of acute exacerbations is unsatisfactory and prognosis extremely poor.

Summary In a critically ill patient proper recognition of an acute exacerbation and of the underlying chronic ILD is warranted because treatment approach varies with the type of ILD. Advances in the understanding of the pathogenesis and treatment of this ‘idiopathic’ phenomenon are reviewed.

3rd Pulmonary Department, Sismanoglio General Hospital, Athens, Greece

Correspondence to I.C. Papanikolaou, MD, 3rd Pulmonary Department, Sismanoglio General Hospital, Athens, Greece Tel: +30 6974305925; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.