Interstitial lung disease

Interstitial lung disease is a general category that includes many different lung diseases that affect the interstitium, a part of theĀ lungs’ anatomic structure between the air sacs and the tiny blood vessels.

In general all interstitial lung diseases cause thickening of the interstitium thus impairing the transfer of oxygen from the air sacs to the tiny blood vessels.

Types of ILD

  1. Idiopathic pulmonary fibrosis
  2. Cryptogenic organizing pneumonia (COP)
  3. Desquamative interstitial pneumonitis
  4. Nonspecific interstitial pneumonitis
  5. Hypersensitivity pneumonitis
  6. Acute interstitial pneumonitis
  7. Interstitial pneumonia
  8. Sarcoidosis
  9. Asbestosis

Symptoms of Interstitial Lung Disease

  1. Shortness of breath which is usually progressive
  2. Dry cough
  3. Extrapulmonary manifestations depending on type of ILD

Diagnosis of ILD

CXR– Usually the first test done may reveal fine lines in the lungs

CT scan of Chest– it is required to specify if the disease is present and what is the pattern of disease involvement of lung

Spirometry– Required to assess functional impairement of lung due to disease and to monitor the course of disease.

Lung Biopsy– may be required to definite type the pattern of lung involvement and type of ILD. Lung biopsy can be done by bronchoscopy which involves passing a endoscope through the nose/mouth into the airways and taking tiny pieces of lung. Other methods include VATS (Video Assisted thoracoscopic lung biopsy), open lung biopsy.

Management options

  1. Corticosteroids
  2. Immunosuppressive agents
  3. Pirfenidione and Nintedanib for Idiopathic pulmonary fibrosis
  4. Oxygen Supplementation
  5. Pulmonary Rehabilitation