Classification of Interstitial LD

Previous Classification of Idiopathic ILD (1969, 1997)

ILD: Most recent classification:
  • Type:
    • Idiopathic 
      • Chronic Fibrotic
      • Smoking Related
      • Acute ILD 
    • ILD due to known causes 

Diagnostic Process for DPLD 

What are the features of various types of Interstitial Lung Disease 

Clinical Question

Patient with RA and ILD is seen in clinic for worsening SOB and fever and Cough. 
CXR is as shown
HRCT is as shown
What is your DDx.

1. Acute exacerbation of ILD
2. Acute atypical pneumonia
3. Heart Failure

BNP was normal. 
Now what is the next diagnostic tests?
Bronchoscopy is done and shows no acute findings other than mild increase in erythema of airway. 

What is the diagnostic criteria for Acute exacerbation of ILD?

Patient did not meet these criteria. 
Hence, Acute atypical pneumonia is diagnosed, and treated with azithromycin.