COPD (Chronic Obstructive Pulmonary Diseases)
Interstitial lung disease (ILD) is an umbrella term used for a large group of diseases that cause scarring (fibrosis) of the lungs. The scarring causes stiffness in the lungs which makes it difficult to breathe and get oxygen to the bloodstream. There are multiple subtypes of ILD and based on if it is secondary to environmental exposure / bird exposure / certain medication autoimmune diseases the treatment depends on that. There is idiopathic ILDs where the cause of lung diseases is not known.
Symptoms
- Shortness of breath
- Cough (predominantly dry, occasional expectorations)
- Chest discomfort
- Fatiguability
- Weight loss
- Hypoxia (reduced oxygen)
Diagnosis
History and fine crepitation on clinical examination should cause a high index of suspicion for a patient having ILD.
Chest X ray and HRCT thorax done with the ILD protocol
Complete PFT – this includes spirometry / lung volumes and diffusion capacity ILD
When the aetiology of the ILD is uncertain and tissue diagnosis is needed, TBLB or cryobiopsy or surgical lung biopsy is advised.
Advise for patients
It is extremely important to do the HRCT thorax from a good centre who routinely do such scans. Most ILDs can be classified radiologically.
Broadly ILD treatment depends on whether it is a fibrotic ILD or inflammatory ILD. Most inflammatory ILDs can progress to fibrotic if not treated well.
Inflammatory ILDs are treated with steroids and immunosuppressants, whereas fibtoric ILDs are treated with antifibtorics.
Progressive and end stage diseases patients who are oxygen dependent are also adviced Lung transplantation.
Pulmonary rehabilitation may also be recommended to improve daily life by giving patients techniques to improve lung efficiency, improve physical endurance and offer emotional support.