II. Epidemiology

  1. Prevalence: 200,000 in U.S.
  2. Mortality: 2,000 deaths per year in U.S

III. Pathophysiology

  1. Fibrotic lung disease secondary to Asbestos inhalation

IV. Symptoms

  1. Dry, non-productive cough
  2. Exertional Dyspnea

V. Signs

  1. Auscultory rales

VI. Imaging

  1. Chest XRay
    1. Interstitial Markings increased (esp. lower lobes)
    2. Pleural Plaques may be present
  2. Consider Chest CT
    1. Interstitial Markings increased as on Chest XRay
    2. Honeycomb appearance

VII. Diagnostics

  1. Pulmonary Function Tests
    1. Initial
      1. Decreased DLCO (diffusion capacity)
      2. Decreased ambulatory Oxygen Saturation
    2. Later
      1. Restrictive Lung Disease
      2. Decreased Vital Capacity of Total Lung Capacity
  2. Lung biopsy
    1. Not indicated in most cases
    2. Interstitial Pneumonia findings (same as IPF)
    3. Asbestos bodies seen on iron staining
      1. Asbestos body quantity correlates with severity

VIII. Differential diagnosis

  1. Idiopathic Pulmonary Fibrosis
    1. IPF is a more rapid progression
  2. Pulmonary fibrosis due to Collagen vascular disease

IX. Associated conditions

  1. Pleural Plaques
  2. Lung Cancer
    1. Use high index of suspicion

X. Management

  1. No specific management
  2. Tobacco Cessation

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