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


RESULTS
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.


CONCLUSIONS
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.
Papanikolaou
Ilias C
IC
3rd Pulmonary Department, Sismanoglio General Hospital, Athens, Greece. hilaspapa@hotmail.com
Drakopanagiotakis
Fotios
F
Polychronopoulos
Vlasis S
VS
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D003095:Collagen Diseases / Q000150:complications; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D017563:Lung Diseases, Interstitial / Q000150:complications / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology*; D011658:Pulmonary Fibrosis / Q000150:complications; D017565:Sarcoidosis, Pulmonary / Q000150:complications; D014652:Vascular Diseases / Q000150:complications
D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents