Interstitial Lung Disease (ILD) refers to a group of lung disorders characterized by inflammation and scarring (fibrosis) of the lung parenchyma in a diffuse manner
Classification
Known cause:
- Industrial dust diseases e.g. asbestosis, berylliosis, silicosis, cotton worker’s lung
- Drugs - nitrofurantoin, bleomycin, amiodarone, sulfasalazine, busulfan
- Hypersensitivity reactions - hypersensitivity pneumonitis
- Infections - Tuberculosis, fungal, viral
- Gastro-oesophageal reflux
Associated with systemic disorder:
Idiopathic
- Idiopathic Pulmonary Fibrosis
- Cryptogenic organising pneumonia
- Non-specific interstitial pneumonitis
Symptoms
- Shortness of Breath: Initially with exertion, but it can progress to occur even at rest.
- Non-productive paroxysmal cough: Often persistent and unrelenting.
- Fatigue: Feeling tired and weak.
- Chest Discomfort: Discomfort or pain in the chest.
- Unintended Weight Loss: Due to the increased effort of breathing.
Signs
- Abnormal CXR
- Crackles in the Lungs: Abnormal lung sounds heard with a stethoscope.
- Clubbing of Fingers and Toes: Abnormal enlargement of fingertips and toes due to chronic low oxygen levels.
Diagnostic Tests
- CXR
| Upper zones | Mid Zone | Lower zone |
|---|---|---|
| TB, Hypersensitivity Pneumonitis | Sarcoidosis, histoplasmosis | Idiopathic Pulmonary Fibrosis |
| Ankylosing spondylitis | Asbestosis | |
| Radiotherapy | ||
| Progressive massive fibrosis |
- High-Resolution CT Scan (HRCT): Imaging to visualize lung abnormalities.
- Pulmonary Function Tests (PFTs): Assess lung function and capacity.
- Bronchoscopy: A procedure to examine the airways and collect samples for analysis.
- Biopsy: Removing a small piece of lung tissue for examination (surgical or transbronchial).
Management
Treatment of ILD depends on the specific type and severity: