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The fibrosing DILD, like idiopathic pulmonary fibrosis, as well as non-specific interstitial pneumonia, pneumonitis due to hypersensitivity, pneumoconiosis, interstitial diseases associated with autoimmune diseases, secondary due to lung toxicity, have two symptoms in common:
Shortness of breath (dyspnoea). It is the main, and most common, symptom of this type of disease. It appears in periods of physical effort, which is known as exertion dyspnoea, which continues to progress gradually and, in more advanced phases of the disease, there may be shortness of breath even at rest.
Cough. It is usually an irritating cough, with no sputum and at no particular time. It may initially pass unnoticed or may be confused as a sign of a prolonged respiratory infection; however, the persistence of the symptom over time, and its intensification must be taken into account as a sign of fibrosing interstitial lung diseases.
In cases of interstitial diseases associated with autoimmune diseases, depending on the cause of the disease, there may be other symptoms, such as: fatigue, joint pains in the hands, hand rigidity, loss of weight, dryness of eyes and/or mouth, and appearance of marks on the skin, in some cases, with exposure to the sun.
The clinical signs that may be found in the assessment of patients with interstitial lung diseases can vary depending on the time of onset of the disease at the time of the assessment.
Among the most relevant signs are:
Dry crackles (Velcro type). They are characteristic of fibrosing DILD and, in particular, pulmonary fibrosis. Its name arises from the noise made by Velcro on separating its two layers, which is audible to the doctor in the auscultation with the stethoscope.
Tachypnoea. This term is also known as rapid breathing.
Acropachy. The characteristic of this sign is the painless and insensitive enlargement of the ends of the fingers and toes, due to a thickening of the tissue found below the nails of the fingers and toes. The nail is curved downwards, similar to the shape of the rounded part of a spoon turned upside down. It is a common sign in cases of idiopathic pulmonary fibrosis, although it can be present in another type of disease.
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Substantiated information by:
Fernanda Hernandez GonzalezPulmonologistPneumology Department
Jacobo Sellarés TorresPulmonologistPneumology Department
Joel FrancesquiPulmonologistPneumology Department
Sandra Cuerpo CardeñosaPulmonologistPneumology Department
Xavier Alsina RestoyAdvanced Nurse PractitionerPneumology Department
Published: 9 June 2020
Updated: 9 June 2020
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