OVERVIEW
Alveolar-capillary block syndrome is a group of conditions in which the interstitial walls of the alveolar-capillaries, which form the gas diffusion surface, are diseased, reducing oxygen diffusion capacity.
Causes
There are many causes of alveolar-capillary gas diffusion, such as interstitial fibrosis due to systemic lupus erythematosus and rheumatoid arthritis, lung damage due to scleroderma, exogenous alveolitis, pulmonary nodulosis, idiopathic interstitial fibrosis, obstructive bronchiolitis with organizing pneumonia, various forms of intrapulmonary sarcoidosis, alveolar cell carcinoma, polypoidal pulmonary micro-thrombosis, pulmonary ferritin deposition, and pulmonary sclerosis. ferritin deposition, alveolar protein deposition, and various forms of drug-induced interstitial fibrosis all fall within the scope of the syndrome.
Symptoms
In addition to the clinical manifestations of the original disease, the onset of the disease is insidious, slow progress, progressive dyspnea, followed by varying degrees of cyanosis, shallow and rapid respiration. Pestle-like fingers (toes) occur after prolonged illness, cough, a small amount of cough sputum, there may be fever, weight loss, etc., and right heart failure may occur in the late stage. Typical signs include inspiratory crackles in both lungs and pestle-shaped fingers.
Examination
1. Restrictive ventilation disorder mainly, and diffusion disorder. There is no obvious obstructive dyspnea and uneven ventilation flow.
2. Diffuse patchy, reticular, gross glassy or honeycomb shadows in both lungs on chest X-ray.
Diagnosis
Based on history and clinical manifestations, laboratory tests and other auxiliary tests. The diagnosis can be made.
Treatment
1. General treatment
When hypoxia is obvious, adequate oxygen can be given, or high-frequency ventilation can be given to give oxygen, but the effect is not great.
2. Adrenal glucocorticoid
Adrenal glucocorticoids are effective in idiopathic pulmonary fibrosis.
3. Treatment of complications
Right heart failure is treated as right heart failure.
Prognosis
The prognosis of this syndrome depends on the primary cause.