Set of pulmonary disorders characterized by reduced lung volumes

Aetiology

Intrinsic restrictive diseases

• Diseases of the lung itself resulting in impaired alveolar gas exchange - type I oxygen failure
• Examples: pneumonia, TB, interstitial lung diseases

Extrinsic restrictive diseases

• Thoracic/extra thoracic - obesity, kypho-scoliosis, ascites, diaphragmatic palsy
• Neuromuscular disorders e.g. motor neuron disease
• Pleural diseases e.g. diffuse pleural thickening, mesothelioma, large pleural effusions
• Impair alveolar ventilation (restrictive hypoventilation) - type II oxygen failure

Clinical features

Symptoms

• Progressive dyspnoea +/- dry cough
• CO2 retention - headache, confusion and lethargy

Signs

• Finger clubbing
• Obese/kyphosis/scoliosis
• Fibrotic crepitations
• Clinical signs of pleural effusions or ascites
• Cyanosis