Interstitial Lung Diseases (ILD)
Progressive scarring of lung tissue.
OVERVIEW
Interstitial lung disease (ILD) is an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream.
KEY FACTS
- It is the name for a group of more than 200 lung disorders that inflame or scar the lungs.
- The cause is often not known.
- Most patients with Rheumatologic conditions also have co-existing ILD.
- The goal of treatment is to prevent more scarring, manage symptoms, and help you stay active and healthy.
What are Interstitial Lung Diseases (ILD)?
ILD refers to a group of disorders that affect the interstitium (space between the air sacs) in the lungs. ILDs are characterized by inflammation and scarring (fibrosis) in the interstitial spaces, which can cause breathing difficulties and impaired lung function.
Types of ILDs
There are numerous types of ILDs, each with unique causes, characteristics, and treatment approaches. Basically it can be classified in two types:
Idiopathic Pulmonary Fibrosis (IPF): This is the most common and severe form of ILD, where the cause is unknown. IPF leads to progressive scarring of the lungs and impaired oxygen exchange.
Known Causes: Environmental factors, autoimmune disorders like rheumatoid arthritis etc., chronic bird/bird droppings exposure.
Symptoms of Interstitial Lung Diseases
The symptoms of ILDs can vary depending on the specific condition and its severity.
Common symptoms include:
- Shortness of breath, especially during physical activity
- Dry cough
- Fatigue
- Chest pain or discomfort
- Unintentional weight loss
- Clubbing of the fingers (enlarged fingertips)
Diagnosis of Interstitial Lung Diseases
Medical history review: The pulmonologist will discuss your symptoms, occupational exposure, and any relevant medical conditions.
Pulmonary function tests (PFTs): These tests measure lung capacity and airflow to assess lung function.
Imaging studies: Chest X-rays or high-resolution computed tomography (HRCT) scans provide detailed images of the lungs, helping to identify abnormalities.
Bronchoscopy: This procedure involves inserting a thin tube with a camera into the airways to examine the lung tissue and collect samples for further analysis.
Lung biopsy: In some cases, a small piece of lung tissue may be obtained for microscopic examination. The latest advancement in diagnosis of ILD is Cryo-biopsy of lung. It combines both Bronchoscopy and cryo-technique to obtain lung tissue for diagnosis.
Treatment of Interstitial Lung Diseases
Due to the numerous causes involved, the treatment for interstitial lung diseases may vary. Unfortunately, some of these diseases lack a definitive cure. The primary focus of treatment is to prevent further scarring of the lungs, alleviate symptoms, and promote an active and healthy lifestyle. It is important to note that treatment cannot reverse existing lung scarring.
Treatment will be based on the type of ILD. Anti-inflammatory drugs, immunosuppressants, and antifibrotic agents may be prescribed to reduce inflammation and slow down disease progression. The main goal of treatment is to halt/slow down the progression of disease, thereby improving the quality of life. Unfortunately, the disease is incurable at present. But very effective drugs are available for different ILD types.
Support and Patient-Care
Living with an ILD can be challenging, both physically and emotionally. Our pulmonology team is dedicated to providing comprehensive support and personalized care to our patients.
Patient Comfort and Safety
We offer educational resources, support groups, and counseling services to assist you in managing your condition effectively.
FAQs
I am a patient with Rheumatologic condition. Should I get my lung screened even though I don’t have respiratory symptoms?
Definitely, formal consultation with a pulmonologist is required to detect the early stages of disease when treatments are very effective. Presence of ILD in a patient with autoimmune condition is very common and goes undetected in early stages of disease.
Is there any definitive cure for ILD?
Definite cure can be lung transplant in selected patients. However lifelong drugs are essential even after lung transplant.
How will we know that the disease is progressing?
Symptomatic assessment, radiologic assessment and functional assessment are done in patients with ILD on follow up. Based on comparison with previous status, progression of disease can be ascertained. That is the reason periodic follow up (3 monthly) follow up is crucial in ILD management.
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