The medical history should cover history of pulmonary diseases and infections, immune system disorders and immunodeficiency and conditions associated with ILD, such as collagen vascular diseases. The link between HIV infection and ILD should not be underestimated. HIV infection predisposes a patient to LIP and to opportunistic infections associated with chronic lung disease. HIV should be high on the list of etiologic suspects in any patient who has diffuse interstitial infiltrates of unidentified origin. Given the typically long latency between exposure and emergence of the infection, the review of HIV risk factors should extend back as many years as necessary to rule out the possibility.
Supportive care remains an essential component in the treatment of adults and children.
Eosinophilic granuloma has a strong association with smoking, but hypersensitivity pneumonitis is almost always associated with a negative history. HRCT has demonstrated good diagnostic accuracy for specific diseases, including UIP, but the imaging technique has shown the most value in the identification of specific disease patterns. Pulmonary function tests should be performed whenever ILD is suspected. The tests typically will reveal restrictive lung impairment. Forced vital capacity and forced expiratory volume at one second are reduced proportionally in most patients.