Pneumoconiosis: Difference between revisions
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==Background== | ==Background== | ||
*Asbestosis: shipping, roofing, plumbing | Pneumoconiosis is a chronic inflammatory lung disease caused by inhalation of particles, typically occupationally related, that typically results in pulmonary fibrosis and eventually restrictive lung disease. | ||
===Types based on inhaled particle=== | |||
*Asbestosis: shipping, roofing, plumbing, demolition | |||
*Berylliosis: aerospace, fluorescent bulbs | *Berylliosis: aerospace, fluorescent bulbs | ||
*Byssinosis: cotton | *Byssinosis: cotton | ||
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*Siderosis: iron | *Siderosis: iron | ||
*Stannosis: tin | *Stannosis: tin | ||
==Clinical Features== | |||
*May be asymptomatic, with normal PFTs, especially initially | |||
*[[Dyspnea]] | |||
*Crackles on exam | |||
*Features of restrictive and/or obstructive pulmonary dysfunction | |||
*If severe, clubbing, cyanosis | |||
==Differential Diagnosis== | |||
{{Pulmonary fibrosis differential}} | |||
==Evaluation== | |||
''Evaluate for and treat for reversible causes of symptoms or exacerbation of symptoms'' | |||
*[[CXR]]: | |||
**Coal workers': diffuse nodular opacities, especially prominent in upper lung | |||
**Silicosis: Large conglomerate densities in upper lung | |||
**Asbestosis: linear streaking at bases, opacities, honeycomb changes if advanced | |||
*CT Chest | |||
**Best imaging for asbestosis, can detect parenchymal fibrosis and characterize pleural plaques | |||
*TB testing | |||
**Increased incidence of TB in patients with silicosis | |||
==Management== | |||
*Treatment is supportive | |||
==Disposition== | |||
==See Also== | |||
*[[Idiopathic pulmonary fibrosis]] | |||
==References== | ==References== | ||
*Meyer KC. Beryllium and lung disease. Chest. Sep 1994;106(3):942-6. | *Meyer KC. Beryllium and lung disease. Chest. Sep 1994;106(3):942-6. | ||
*Kreiss K, Miller F, Newman LS, Ojo-Amaize EA, Rossman MD, Saltini C. Chronic beryllium disease--from the workplace to cellular immunology, molecular immunogenetics, and back. Clin Immunol Immunopathol. May 1994;71(2):123-9. | *Kreiss K, Miller F, Newman LS, Ojo-Amaize EA, Rossman MD, Saltini C. Chronic beryllium disease--from the workplace to cellular immunology, molecular immunogenetics, and back. Clin Immunol Immunopathol. May 1994;71(2):123-9. | ||
[[Category:Pulmonary]] | [[Category:Pulmonary]] | ||
Revision as of 20:29, 28 August 2017
Background
Pneumoconiosis is a chronic inflammatory lung disease caused by inhalation of particles, typically occupationally related, that typically results in pulmonary fibrosis and eventually restrictive lung disease.
Types based on inhaled particle
- Asbestosis: shipping, roofing, plumbing, demolition
- Berylliosis: aerospace, fluorescent bulbs
- Byssinosis: cotton
- Silicosis: foundries, sandblasting, mines
- Coal worker's lung: coal
- Siderosis: iron
- Stannosis: tin
Clinical Features
- May be asymptomatic, with normal PFTs, especially initially
- Dyspnea
- Crackles on exam
- Features of restrictive and/or obstructive pulmonary dysfunction
- If severe, clubbing, cyanosis
Differential Diagnosis
Pulmonary Fibrosis
- Interstitial pneumonias (acute, lymphocytic)
- Lung malignancy
- Aspiration pneumonia or pneumonitis
- Bacterial, viral, or fungal pneumonia
- Cryptogenic organizing pneumonia
- Interstitial lung disease associated with collagen vascular disease
- Drug-induced pulmonary toxicity (amiodarone, bleomycin, amphotericin B, carbamazepine, etc.)
- Eosinophilic granuloma (Histiocytosis X)
- Radiation pneumonitis
- Sarcoidosis
- Pneumoconiosis (Workplace exposure)
- Asbestosis
- Berylliosis
- Chemical worker's lung
- Coal worker's pneumoconiosis
- Silicosis
Evaluation
Evaluate for and treat for reversible causes of symptoms or exacerbation of symptoms
- CXR:
- Coal workers': diffuse nodular opacities, especially prominent in upper lung
- Silicosis: Large conglomerate densities in upper lung
- Asbestosis: linear streaking at bases, opacities, honeycomb changes if advanced
- CT Chest
- Best imaging for asbestosis, can detect parenchymal fibrosis and characterize pleural plaques
- TB testing
- Increased incidence of TB in patients with silicosis
Management
- Treatment is supportive
Disposition
See Also
References
- Meyer KC. Beryllium and lung disease. Chest. Sep 1994;106(3):942-6.
- Kreiss K, Miller F, Newman LS, Ojo-Amaize EA, Rossman MD, Saltini C. Chronic beryllium disease--from the workplace to cellular immunology, molecular immunogenetics, and back. Clin Immunol Immunopathol. May 1994;71(2):123-9.