Pulmonary fibrosis

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Causes

By Mayo Clinic staff

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Illustration showing lung anatomy 
Bronchioles and alveoli

Pulmonary fibrosis scars and thickens the tissue around and between the air sacs (alveoli) in your lungs. This makes it more difficult for oxygen to pass into your bloodstream. The damage can be caused by many different things — including airborne toxins in the workplace, certain lung diseases and even some types of medical treatments.

Occupational and environmental factors
Long-term exposure to a number of toxins and pollutants can damage your lungs. These may include:

  • Silica dust
  • Asbestos fibers
  • Grain dust
  • Bird and animal droppings

Radiation treatments
Some people who receive radiation therapy for lung or breast cancer show signs of lung damage months or sometimes years after the initial treatment. The severity of the damage depends on:

  • How much of the lung was exposed to radiation
  • The total amount of radiation administered
  • Whether chemotherapy also was used
  • The presence of underlying lung disease

Medications
Many drugs can damage your lungs, especially:

  • Chemotherapy drugs. Drugs designed to kill cancer cells, such as methotrexate (Trexall) and cyclophosphamide (Cytoxan), can also damage lung tissue.
  • Heart medications. Some drugs used to treat irregular heartbeats, such as amiodarone (Cordarone, Nexterone, Pacerone) or propranolol (Inderol, Inderide, Innopran) may harm lung tissue.
  • Some antibiotics. Nitrofurantoin (Macrobid, Macrodantin, others) and sulfasalazine (Azulfidine) can cause lung damage.

Medical conditions
Lung damage can also result from:

  • Tuberculosis
  • Pneumonia
  • Systemic lupus erythematosus
  • Rheumatoid arthritis
  • Sarcoidosis
  • Scleroderma

Idiopathic pulmonary fibrosis: When the cause isn't known
The list of substances and conditions that can lead to pulmonary fibrosis is long. Even so, in most cases, the cause is never found. Pulmonary fibrosis with no known cause is called idiopathic pulmonary fibrosis.

Researchers have several theories about what might trigger idiopathic pulmonary fibrosis, including viruses and exposure to tobacco smoke. And because one type of idiopathic pulmonary fibrosis runs in families, heredity also is thought to play a role.

References
  1. Idiopathic pulmonary fibrosis. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/ipf/ipf_all.html. Accessed Jan. 20, 2011.
  2. Rust G. Interstitial lung diseases. In: Rakel RE. Textbook of Family Medicine. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/191205553-4/0/1481/0.html#. Accessed Jan. 20, 2011.
  3. King TE. Approach to the adult with interstitial lung disease: Clinical evaluation. http://www.uptodate.com/home/index.html. Accessed Jan. 20, 2011.
  4. Blundin M. Idiopathic pulmonary fibrosis. In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&about=true&uniqId=230100505-53. Accessed Jan. 20, 2011.
  5. King TE. Approach to the adult with interstitial lung disease: Diagnostic testing. http://www.uptodate.com/home/index.html. Accessed Jan. 20, 2011.
  6. Rosenow EC (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 25, 2011.
  7. King TE. Treatment of idiopathic pulmonary fibrosis. http://www.uptodate.com/home/index.html. Accessed Jan. 20, 2011.
  8. Pulmonary rehabilitation. National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/pulreh/pulreh_all.html. Accessed Jan. 20, 2011.
DS00927 March 15, 2011

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