What are the causes of lung fibrosis?

The causes of lung fibrosis

Apical lung fibrosis:

  • TB
  • Extrinsic allergic alveolitis (farmer's lung; bird fancier's disease)
  • Ankylosing spondylitis
  • Allergic bronchopulmonary aspergillosis
  • Radiation
  • Sarcoidosis
  • Histiocytosis lX

Fibrosis predominantly affecting the upper zone:

  • Extrinsic allergic alveolitis 
  • Coal worker's pneumoconiosis/ progressive massive fibrosis 
  • Silicosis 
  • Sarcoidosis 
  • Histiocytosis 
  • Tuberculosis 
  • Ankylosing spondylitis (rare)
  • Cyclophosphamide induced fibrosis 

Fibrosis predominantly affecting the lower zone: 

  • Cryptogenic fibrosing alveolitis 
  • Most connective tissue disorders e.g. rheumatoid arthritis, systemic sclerosis (except Ankylosing spondylitis)
  • Drug-induced: amiodarone, bleomycin, methotrexate 
  • Asbestosis 
  • As a late complication of aspiration pneumonia 


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