Causative & risk factors
ILD can be idiopathic or may occur due to exposure to toxic substances or even due to certain autoimmune conditions.
Long term exposure to fibers or dust of toxic substances such as asbestos, silica, talc, coal dust, bird droppings or even grain dust can lead to ILD. In addition, frequent radiation therapy in the chest region can also cause ILD.
Autoimmune diseases like Rheumatoid arthritis, SLE, scleroderma, sarcoidosis etc. can cause ILD. Certain chemotherapeutic drugs, antibiotics and heart drugs can also cause ILD.
Clinical presentation
All patients with interstitial lung disease suffer from shortness of breath. Some may even have a non-productive cough. The patient may lose weight without trying.
A few common types of ILD include:
- Idiopathic pulmonary fibrosis – A chronic form of ILD, the cause of which is unknown.
- Interstitial pneumonia – Caused by infection with bacteria, viruses or fungi.
- Cryptogenic organizing pneumonia – A pneumonia like illness, but occurring in the absence of infection.
- Acute interstitial pneumonitis – A sudden, severe form of ILD.
- Nonspecific interstitial pneumonitis – Associated with autoimmune conditions such as SLE or rheumatoid arthritis.
- Hypersensitivity pneumonitis – Caused by chronic inhalation of irritants like dust, mold etc.
- Desquamative interstitial pneumonitis – A form of ILD that is partially associated with smoking.
- Asbestosis – ILD caused specifically by exposure to asbestos
Patients with long-standing interstitial lung disease may develop complications such as pulmonary hypertension, cor pulmonale and respiratory failure.
Investigations
Imaging tests such as X-ray or CT scan of the chest will be carried out in all patients suspected with lung disease. Pulmonary function tests are performed to assess the functional capacity of the lung. To determine the type of interstitial lung disease, a lung biopsy may be performed.
Treatment
The lung tissue scarring in patients with ILD is irreversible. Treatment aims at relieving symptoms and preventing further deterioration.
Corticosteroids, antibiotics and certain other medications are prescribed in patients with ILD.
Since most patients of ILD suffer from low blood oxygen levels, oxygen therapy is helpful. The patients are advised to undergo pulmonary rehabilitation to improve the breathing technique in order to improve the lung efficiency.
When no other treatment works or the lung damage is too severe, lung transplantation can be considered.
