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Interstitial Pulmonary Fibrosis (Farmer's Lung) (Signs (Reduced…
Interstitial Pulmonary Fibrosis
(Farmer's Lung)
Pathophysiology
Repeated exposure environmental irritants (organic dust, moldy hay/crops, allergens, antigens)
Neutrophils and Lymphocytes invade alveoli
Recruitiment of additional Inflammatory mediators (Cytokines)
Diffuse inflammation process occurs distal to terminal bronchiole (Alveolitis = inflammation of alveoli)
Repeated exposure causing repeated acute inflammation attacks; continuous cellular tissue response
Excessive accumulation of extracellular matrix and inflammatory cells
Scarring of the alveoli
Alveoli restriction due to fibrosis
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Symptoms
Early
Dyspnea on exertion
Chronic unproductive cough
Fatigue
Late
Worsening dyspnea
Cyanosis
Crackles on auscultation
Decreased costal expansion
Finger clubbing
Signs
Reduced diffusing capacity
Decreased PaO2 with exercise
Decreased lung compliance
Decreased PaCO2 due to hyperventilation
Compensatory decrease in HCO3
Decreased lung volumes & capacities
Eventually, PaO2 is greatly reduced due to V/Q mismatch & thickened alveolar membranes
Risk Factors
Type of occupation
Farmer, vegetable and dairy workers, Bird and poultry handlers, Veterinary workers, Grain and flour processing and loaders, Lumber milling, wood stripping, paper and wallboard manufacturers
Any occupation where the quality of air is compromised that can trigger the immune response
Restrictive lung diseases
Pneumoconiosis
Scleroderma
Sarcoidosis
Pleural effusion
Genetic predisposition
Thoracic changes (kyphoscoliosis)
Obesity
