Etiological evaluation of interstitial lung diseases appliedto the polyclinic of chest diseases department of DicleUniversity Faculty of Medicine

Interstitial lung diseases (ILD) encompass many acute and chronic lung diseases with comman clinical, radiological and physiological features. In our study, we aimed to evaluate the demographic characteristics, clinical and radiological findings, diagnostic methods and treatment modalities of patients with radiological ILD pattern who applied to our outpatient clinic. 103 patients who applied to our outpatient clinic between June 15,2023 and December 15,2023 were included in our study. Patients were evaluated by grouping according to their diagnosis. 61,2% of our patients were male and 38,8% were female. The average age of the patients was 55,27 ± 15,56. (min: 18 – max:84) 5,8% of patients had occupational allergen exposure, 27,8% had animal exposure, 26,2% had asbestos exposure and 2,9% had radiation exposure. 29,1% of the patients were active smokers and 27,2% were exsmokers. The average BMI of the patients was 27,17 ± 8,30 and 40,8% were preobese and 20,4% were obese. The most common accompanying chronic diseases were collagen tissue disease and hypertension. The most common presenting complaints of the patients were shortness of breath (84,5%), cough (65%), weakness and fatigue (59,2%). The most common physical examination findings were crackles and finger clubbing. Thirty (29,1%) of our patients were diagnosed with idiopathic pulmonary fibrosis (IPF), 22 (21,4%) with collagen tissue disease (CTD), 14 (13,6%) with hypersensitivity pneumonitis (HSP), 10 (9,7%) with sarcoidosis, 9 (8,7%) with idiopathic nonspecific interstitial preumonia (iNSIP), 4 (3,9%) with pleuroparenchymal fibroelastosis (PPFE), 3 (2,9%) with respiratory bronchiolitis and interstitial lung disease (RB-ILD), 3 (2,9%) with pulmonary alveolar proteinosis (PAP) , 2 (1,9%) with pulmonary langerhans cell histiocytosis (PLCH), 2 (1,9%) with chronic eosinophilic pneumonia (CEP), 2 (1,9%) with radiation pneumonitis, 1 (1%) with eosinophilic granulomatous polyangiitis (EGPA), 1 (1%) with unclassifiable IIP. When the diagnostic methods were examined, 83,5% were diagnosed only clinically and radiologically, while 16,5% were diagnosed using a clinical-radiological and invasive method. 25,2% of our patients underwent fiber optic bronchoscopy. Biopsies were performed on 24 patients and 13 were evaluated as diagnostic. Transbronchial biopsy was performed in 11 patients, fine needle biopsy was performed in 6 patients, surgical lung biopsy was performed in 5 patients and trucut biopsy was performed in 2 patients. While 9 patients were followed up without treatment, steroid treatment was prescribed to 51 patients, anti-fibrotic treatment to 35 patients and inhaler treatment to 42 patients. In conclusion, ILD are not rare diseases and should always be taken into consideration in the differential diagnosis of patients applying to chest diseaes outpatient clinics. In our study the most common were IPF, CTD-ILD, HSP. Despite multidisciplinary evaluation, advanced radiological methods and biopsy techniques, sometimes casesmay remain undiagnosed. Keywords : idiopathic interstitial pneumonias, sarcoidosis, collagen tissue diseaes, idiopathic pulmonary fibrosis, hypersensitive pneumonia