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Table 2 Clues from the initial evaluation that suggest specific types of ILD

From: Diagnosis and management of interstitial lung disease

History elicited Frequently associated ILD or complications of ILD
Rapid onset and worsening AIP
Infection
Acute HP, acute EP
Drug reaction
COP
CTD (e.g. acute lupus pneumonitis)
DAH (e.g. GPS)
Smoking RB-ILD, DIP, PLCH
Occupation: Pipefitter, foundry worker, coal miner, Pneumoconiosis
Pneumotoxic drug exposure Drug-induced ILD
Hemoptysis DAH, pulmonary capillaritis, pulmonary venoocclusive disease, LAM
Superimposed complications (e.g. pulmonary emboli, lung neoplasm)
Pleurisy CTD (SLE, RA)
Wheezing HP, EP
Eye symptoms CTD, sarcoidosis, PAG
Impaired vision combined with albinism & Puerto Rican heritage HPS
Rash Sarcoidosis, CTD
Exposure to organic antigens at home or at work (e.g. birds, grain dust, humidifiers, visible molds, hot tubs,etc.) HP
Occupational ILD
Abnormal GER, GERD, dysphagia CTD (especially scleroderma), IPF
Sicca symptoms Sjögren’s disease
Raynaud’s phenomenon CTD
Arthralgias, arthritis CTD, sarcoidosis
Myalgias, muscle weakness DM-PM
Morning stiffness RA, CTD
Age >70 years IPF > other ILD if HRCT suspicious for IIP
  1. AIP = acute interstitial pneumonia; COP = cryptogenic organizing pneumonia; CTD = connective tissue disease; DAH = diffuse alveolar hemorrhage; DM-PM = dermatopolymyositis; EP = eosinophilic pneumonia; GER = gastroesophageal reflux; GERD = gastroesophageal reflux disease; GPS = Goodpasture’s syndrome; HP = hypersensitivity pneumonitis; HPS = Hermansky-Pudlak syndrome; IIP = idiopathic interstitial pneumonia; IPF = idiopathic pulmonary fibrosis; LAM = lymphangioleiomyomatosis; PAG = polyangiitis with granulomatosis; PLCH = pulmonary Langerhans cell histiocytosis; SLE = systemic lupus erythematosus; RA = rheumatoid arthritis.
  2. Reprinted with permission from Interstitial Lung Disease: A Practical Approach. Meyer KC, Raghu G: Patient evaluation. Second Edition, New York: Springer; 2011:3–16.