Causes and classification of interstitial lung disease in adults

A classification of the major interstitial lung diseases (ILDs) in adults is shown in Classification of major interstitial lung diseases in adults.

The aetiology of ILDs is wide-ranging and may be associated with environmental and occupational exposures (eg smoking, drugs, radiation, asbestos), systemic autoimmune disease (eg systemic sclerosis, rheumatoid arthritis) and genetic disorders. A definite cause has not been identified in some ILDs (eg idiopathic pulmonary fibrosis, sarcoidosis).

Figure 1. Classification of major interstitial lung diseases in adults

Idiopathic interstitial pneumonias

Multisystem disorders

Environmental or lifestyle exposures

  • smoking-related interstitial lung disease (eg respiratory bronchiolitis–interstitial lung disease, Langerhans cell histiocytosis, desquamative interstitial pneumonia)
  • hypersensitivity pneumonitis
  • occupational lung disease (eg asbestosis, silicosis, coal worker’s pneumoconiosis, mixed dust pneumoconiosis)
  • drug-induced interstitial lung disease (eg caused by amiodarone, leflunomide, methotrexate, nitrofurantoin, or some oncology and immunomodulatory drugs [NB1])
  • radiation-induced interstitial lung disease

Genetic

  • familial idiopathic pulmonary fibrosis
  • short telomere syndromes

Other

  • lymphangioleiomyomatosis
  • pulmonary alveolar proteinosis
  • eosinophilic pneumonia
Note:

NB1: A comprehensive list of drugs associated with interstitial lung disease is available on the Drug-induced Respiratory Disease website.