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Monday, March 7, 2011


Pulmonary fibrosis caused by the inhalation of asbestos fibres is characterised by increasing exertion/breathlessness.
Finger clubbing is usually present and end inspiratory crepitations (crackles) are audible over the lower zones of both lungs.
The radiological changes are usually confined to the lower two-thirds of the lung fields and comprise mottled shadows with some streaky opacities and sometimes 'honeycombing'. The cardiac silhouette often appears 'shaggy'.

The most important physiological abnormalities are abnormalities are a reduced carbon monoxide transfer factor, decreased lung volumes and a restrictive ventilatory defect.

Respiratory and right ventricular failure eventually supervene. The incidence of bronchial carcinoma is much increased. and is at least ten fold in person suffering from asbestosis who also smoke.

The diagnosis is usually easy to establish from the history of exposure to asbestos, the clinical features of end-inspiratory crepitations and finger clubbing, the pulmonary function test abnormalities and the chest X-ray which also often show pleural plaques. Open lung biopsy may be required to confirm the diagnosis but is not without risk and should not be undertaken solely for the purposes of allowing patients to claim benefit.

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