Interstitial Lung Disease

Interstitial Lung Disease (ILD) is a group of over 200 lung conditions causing inflammation and scarring of the lungs.

These conditions affect a part of the lungs called the interstitium, which supports the tiny air sacs of the lungs called the alveoli.

Though it primarily affects the alveoli, other parts of the lungs, such as the airways, blood vessels, and the lining of the lung, may also be affected.

Also known as diffuse parenchymal lung disease (DPLD), the damage caused by interstitial lung disease is usually irreversible.

Having ILD can damage the parts of the lungs that help get oxygen into the blood and out to the tissues. This lack of oxygen can cause various interstitial lung disease symptoms, such as:

• Difficulty in breathing
• Dry cough
• Chronic tiredness
• Discomfort in the chest
• Chest pain
• Unusual sounds while breathing
• Fingers and toes clubbing
• Bleeding in lungs
• Appetite loss

Interstitial lung disease can have both known as well as unknown causes.

The known causes can be certain medical conditions, side effects, allergies to certain medications, or exposure to toxic substances. When the causes are unknown, it is known as idiopathic interstitial lung disease.

The following are the known causes of ILD:

• Autoimmune conditions such as:
  • Lupus
  • Dermatomyositis
  • Polymyositis
  • Mixed connective tissue disease
  • Vasculitis
  • Rheumatoid arthritis
  • Sarcoidosis
  • Sjögren syndrome
  • Scleroderma
• Exposure to certain toxic substances such as:
  • Asbestos fibres
  • Coal dust
  • Grain dust
  • Silica dust
  • Smoke of tobacco
  • Moulds
  • Animal protein, e.g., through farming or poultry rearing
• Certain medications, such as:
  • Drugs for chemotherapy, such as bleomycin, gemcitabine, and methotrexate.
  • Certain medicines for the heart, such as amiodarone.
  • Antibiotics such as nitrofurantoin and daptomycin.
  • Non-steroidal anti-inflammatory drugs (NSAIDs).

Interstitial lung disease diagnosis can be derived through a physical exam, testing the patient’s lung function, and getting an interstitial lung disease X-ray.

During the medical exam, we ask patients about their and their family’s medical history, medications, work, or hobbies to determine if they were exposed to any causes of ILD.

We also check for any unusual sounds while they are breathing and perform certain tests for interstitial disease diagnosis, such as:

• Imaging tests
• Pulmonary function tests
• Blood tests
• Bronchoscopy
• Biopsy

Over 200 different types of interstitial lung disease exist. All of them cause the interstitium to thicken either from scarring, inflammation, or fluid buildup.

Following are some of the types of interstitial lung disease:

• Nonspecific interstitial pneumonitis: Often found affecting people with autoimmune conditions such as scleroderma or rheumatoid arthritis.
• Bronchiolitis obliterans: A condition causing blockages in the bronchioles.
• Chronic silicosis: A condition caused by breathing in the mineral silica.
• Hypersensitivity pneumonitis: Inflammation of the alveoli caused by breathing in dust, mould, or other irritants over a long period of time.
• Asbestosis: Inflammation and scarring of the lungs due to breathing in a fibre used in building materials called asbestos.
• Interstitial pneumonia: A condition caused by bacteria, viruses, or fungi that can infect the interstitium.
• Idiopathic pulmonary fibrosis: A condition causing scar tissue in the interstitium. The cause of this is unknown.
• Acute interstitial pneumonitis: A severe and sudden interstitial lung disease where the patient has to be connected to a ventilator to breathe.
• Desquamative interstitial pneumonitis: A lung inflammation condition caused by smoking.
• Sarcoidosis: A condition that causes small clumps of inflammatory cells to form in organs like lymph nodes and lungs.
• Cryptogenic organising pneumonia (COP): Also known as bronchiolitis obliterans with organising pneumonia (BOOP), this is a pneumonia-like interstitial lung disease without an infection.

Some of these interstitial lung disease types are acute, while others are chronic.

Interstitial lung disease is chronic and has no cure as such. It cannot be reversed once it occurs. However, certain medications can slow down disease progression. Interstitial lung disease treatment thus mainly focuses on improving the symptoms.

We may recommend the following medications and treatments for ILD:

• Antibiotics and antifungals to treat interstitial pneumonia caused by bacteria and fungus.
• Corticosteroids to reduce the inflammation in the lungs.
• Oxygen therapy to improve oxygen levels, if they are low.
• Certain biological drugs to treat autoimmune diseases and other ILD causes.
• Pulmonary rehabilitation to strengthen the lungs and make breathing easier.
• Anti-fibrotic and cytotoxic drugs to slow down lung scarring.
• GERD treatment to keep stomach acid down as it may worsen ILD.
• Lung transplant in severe cases of ILD.

Though individuals cannot prevent interstitial lung disease entirely, as many causes aren’t preventable, they can reduce the risk of ILD by avoiding breathing in any harmful substances.

Patients can also follow these steps to prevent ILD:

• Avoiding or wearing a mask while working around harmful and toxic substances or substances causing chronic allergic reactions, e.g., heating and cooling systems, metal dust, certain chemicals, etc.
• Avoid smoking.
• Talking to healthcare providers about managing or preventing ILD in the presence of an underlying disease that can cause ILD, such as sarcoidosis.

Interstitial lung disease is chronic and incurable. The damage caused is irreversible; patients can only manage the symptoms and slow disease progression.

For patients concerned about having any interstitial lung disease symptoms, we recommend making an appointment at the nearest CK Birla Hospital; we have a dedicated department to manage such critical pulmonary conditions.

With the help of advanced technology, our team of expert pulmonologists supports patients by proactively diagnosing ILD and protecting their lungs from further damage.

We also counsel patients on managing ILD and advise them to adopt certain lifestyle changes to improve their quality of life. We ensure all this while being empathetic and prioritising patients’ comfort from the very outset.

Book an appointment now and consult with Dr. Kuldeep Grover.