Restrictive Lung Disease

Aka: Restrictive Lung Disease, Restrictive Pulmonary Disease, Restrictive Lung Function

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II. Causes: Chest Wall

  1. Ankylosing Spondylitis
  2. Kyphosis
  3. Morbid Obesity
  4. Scoliosis

III. Causes: Medications

  1. Amiodarone
    1. Pulmonary fibrosis
  2. Methotrexate
    1. Pulmonary fibrosis
    2. Hypersensitivity Pneumonitis
  3. Nitrofurantoin
    1. Acute Nitrofurantoin Pulmonary Toxicity

IV. Causes: Interstitial Lung Disease

  1. See Interstitial Lung Disease
  2. Asbestosis
  3. Berylliosis
  4. Eosinophilic Pneumonia
  5. Hypersensitivity pneumonitis
  6. Idiopathic Pulmonary Fibrosis
  7. Sarcoidosis
  8. Silicosis (late stage)

V. Causes: Neuromuscular

  1. Amyotrophic Lateral Sclerosis (ALS)
  2. Guillain-Barre Syndrome
  3. Muscular Dystrophy
  4. Myasthenia Gravis

VI. Diagnosis: Pulmonary Function Test

  1. See Pulmonary Function Test
  2. Criteria
    1. FEV1 to FVC Ratio >0.7 (or >LLN or for children>85% of predicted) AND
    2. FVC < LLN (or for age 5 to 18 years old, <80% of predicted)
  3. Assess Severity
    1. FVC over 80%: Normal
    2. FVC over 60%: Mild Restrictive Lung Disease
    3. FVC over 40-50%: Moderate Restrictive Lung Disease
    4. FVC under 50%: Severe Restrictive Lung Disease
  4. Additional testing
    1. Diffusing lung capacity for Carbon Monoxide (DLCO)
    2. DLCO to alveolar volume ratio
    3. Expiratory Reserve Volume
  5. Precaution
    1. Note that mixed obstructive-Restrictive Lung Disease can also occur

VII. References

  1. Johnson (2014) Am Fam Physician 89(5): 359-66 [PubMed]

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