Interstitial lung disease (ILD) also called diffused parenchymal lung disease (DPLD) is a lung disease with many types that affects the interstitium (the tissue & around the alveoli).
It occurs when an injury to the lung brings about an abnormal immune response, therefore in ILD the repair process gets affected & the tissue generated around the alveoli becomes scarred & thickened.
This leads to decreased flow of oxygen to the blood flow.
SIGNS & SYMPTOMS
ILD has classic symptoms of lung diseases:
- Shortness of breath
- Cough
- Mucus
- Inflammation
- Chest discomfort
- Wheezing
COMPLICATIONS
- High blood pressure in the arteries present in the lungs.
- Right side heart failure
- Respiratory collapse.
CAUSES OF ILD
Idiopathic causes:
- Pulmonary fibrosis
- Desquamative interstitial pneumonia
- Acute interstitial pneumonia
- Non-specific interstitial pneumonia
- Respiratory bronchiolitis
- Lymphoid interstitial pneumonia
Secondary causes:
- Sarcoidosis
- Rheumatoid Arthritis
- Lupus
- Systemic sclerosis
- Polymyositis
- Dermatomyositis.
RISK FACTORS FOR ILD
Due to inhaled substances:
- Silicosis
- Asbestosis
- Berylliosis
- Coal dust
- Talc
- Industrial printing chemicals.
Drug related:
- Antibiotics
- Chemotherapy agents
- Anti-inflammatory drugs
- Anti-arrhythmic drugs.
Due to infection & diseases:
- Covid-19
- Tuberculosis
- Chlamydia
- Inflammation of lymph vessels.
Other factors:
- Age
- Autoimmune diseases
- GERD
- Genetic factors
- Smoking.
DIAGNOSIS OF ILD
- Chest X-ray shows scarring present around the lungs.
- High resolution CT scan,
- Lung function test or spirometry for assessment of the health of the lungs.
- Oximetry for measurement of oxygen saturation in the blood.
- Biopsy of lung tissue for accurate diagnosis & detailed study of scarring.
- Bronchoscopy for visual of the bronchioles.
- Genetic testing of DNA.
TREATMENT OF ILD
Medications:
- Antibiotics for treatment of infectious pneumonia.
- Anti-TB drugs
- Corticosteriods for dealing with inflammation.
- Immunosuppressants
- Inhalational oxygen therapy
- Drugs for management of pulmonary fibrosis.
- Pulmonary rehab
- N- acetylcysteine, potent antioxidant to slow the decline of lung function in some forms of ILD.
Surgery:
- Lung transplant
PREVENTION & MANAGEMENT
- Stopping of smoking.
- Preventing of exposure to effluents & smoke.
- Vaccinations for infectious diseases.