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Types and causes of restrictive lung disease

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The causes of restrictive lung disease are numerous but there are only two types.  The causes relate to the diseases associated with it.  The types have to do with the mechanisms that produce it.  They are intrinsic and extrinsic factors.

What is restrictive lung disease?    

Restrictive lung disease (RLD) is not a single or specific disease.  Rather, it is a category of conditions that causes of restrictive lung diseasePhysical properties of the lungs sketch in gray restrict lung compliance.  Lung compliance is the ability of the lungs to stretch or expand to allow an increase in the volume of air during inspiration (taking a breath).  Thus, it reduces IC and TLC.  One of the most common clinical features of it is difficulty taking a deep breath.  It increases the work of breathing.  

Intrinsic restrictive lung disease

Intrinsic restrictive lung disease is a group of diseases in which the decreased lung compliance is due to actual lung stiffness.  The pathology might involve the lung parenchyma, interstitium, or both; of which inflammation and fibrosis are most common.

CAUSES OF INTRINSIC RESTRICTIVE LUNG DISEASE

The term – causes of RLD – is somewhat of a misnomer inasmuch as the purported causes are really just other diseases with which it is associated.  Since the cause of those diseases is usually unknown, the cause of the cause of RLD is also unknown in most cases.  Suffice it to say however, knowledge of the linked diseases is a practical starting point for a partial understanding of it.

Common diseases linked to intrinsic restrictive lung disease are the following:I

1.  Asbestosis

2.  Silicosis

3.  Coal workers pneumoconiosis

4.  Beryliosis

5.  Byssinosis

Extrinsic restrictive lung disease  

Extrinsic restrictive lung disease is a state of restricted lung expansion due to factors outside of the lungs. mechanics of breathingThose factors can be around the lungs, below the diaphragm, or of the neuromuscular unit that is a part of the breathing process.  Factors around the lungs pertain to the chest wall and adjacent spine. The lungs per se are not stiff in this form of the disease but they function as if they are because these factors alter the mechanics of breathing.

CAUSES OF EXTRINSIC RESTRICTIVE LUNG DISEASE

Common causes of extrinsic restrictive lung disease are the following:

  • Chest wall disorders  

1.   Kyphoscoliosis – lateral hunchback deformity of the spine  

2.   Scoliosis – lateral, often S-shaped, curvature of the spine

3.  Rib fracture(s)

4.  Ankylosing spondylitis

5.  Obesity

  • Pleural disease

1.  Pleural effusion

2.  Pleurisy

3.  Pneumothorax

  • Neuromuscular disorders

1.  Myasthenia gravis

2.   Guillain Barré syndrome

3.  Amyotrophic lateral sclerosis (Lou Gehrig’s disease)

4.  Polio

  • Below the diaphragm issues

1.   Ascites   

2.  Pregnancy

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