Interstitial Lung Disease
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January 28, 2020 | Farah Jassawalla

Interstitial Lung Disease

 
 
Interstitial Lung Disease (ILD) is a class of lung diseases that cause scars in the lungs. These lead to the stiffness of the lungs and, hence, difficulty in breathing. ILD damages the interstitium, which is a thin tissue in the lungs. Due to the thinness of the tissue, ILD is difficult to detect as the tissue does not appear in a normal X-ray, MRI, or CT scans.
 

Types of Interstitial Lung Diseases

There are various forms of ILDs; some are temporary, while others can be chronic and often lethal. Here are some common ILDs:
•   Asbestosis: This is an ILD caused by breathing asbestos – a key fiber used in building material. Asbestos was a popular compound used in insulation of buildings during the 20th century, but it was banned due to its harmful nature. Even though it is banned in most countries, it continues to be used in many underdeveloped countries. Traces of asbestos remain in some old military equipment till date, which is why asbestosis is still a common ILD, especially among soldiers. 
•  Sarcoidosis: This ILD is caused when large amounts of inflammatory cells build up in the lungs and possibly other organs when your immune system fights off bacteria or viruses. Sarcoidosis mostly irritates the lungs, but it can lead to irritation and infection in other body parts such as heart, skin, eyes, or nerves.
• Interstitial pneumonia or pneumonitis: These forms of ILDs are caused when bacteria, viruses, or fungi infect the interstitium. Most of the time, the infection is bacterial and affects people with existing autoimmune diseases like scleroderma.
 

Symptoms

• Shortness of breath: Patients suffering from ILD most commonly exhibit this symptom. The shortness of breath gets worse with time, so it can become fatal if the disease is left untreated.
• Cough: Patients with ILD dry cough excessively, meaning mucus is not brought up when they cough.
• Weight loss: ILD causes gradual and abnormal weight loss, which can contribute to making the ILD more lethal.
 

Causes

Several causes can lead to the development of ILD, which include:
•       Asbestos exposure or poisoning
•       Consuming bird proteins commonly found in exotic bird and pigeons
•       Excessive intake of coal, metal or grain dust found in construction or mining sites and farms
•       Breathing of silica and talc
•       Certain drugs with extreme side effects like amiodarone and bleomycin.
 

Detection and diagnosis

Firstly, the doctor must investigate whether a patient has ILD, which can be done in a couple of ways:
• High-resolution CT scan: Since the interstitium is a thin issue, it is tough to detect an ILD using a normal CT scan. Thus a high-resolution CT scan must be used to diagnose the ILD. 
• Lung function test: A patient is required to breathe through a tube that measures the lung capacity of the patient. Since ILD causes reduced lung capacity, it can help detect if the person has an ILD and what stage the ILD is at.
Once ILD is confirmed in a patient, the doctor must find out what kind of ILD it is. For this, a lung biopsy needs to be performed, which is when lung tissue is collected and studied under a microscope.
 

Treatment

Treatment of ILD can involve a few different approaches depending on which ILD you have. Possible treatments include:
•       Antibiotics: If the ILD is bacterial and in the early stages, antibiotics can fight the infection, and full recovery can be made in a month.
•       Inhaled oxygen: Inhaling oxygen can prevent further damage to the lungs or other organs.
•       Taking corticosteroids: Taking corticosteroids causes a reduction of inflammation in the lungs.
•       Lung transplant: If the ILD is in an advanced stage, and the lung is severely impaired or damaged, then a lung transplant may be needed. A lung transplant can usually let the patient recover in a few months.
 
All in all, to avoid and prevent ILD, you should try to breathe clean air by using air purifiers at home and using a smoke mask when outside the home. Additionally, avoid smoking and get yearly lung checks. If you do happen to develop an ILD, do not worry as they are treatable, and in most cases, full recovery will be made. Nonetheless, they should be avoided at all costs as they can lead to organ damage.

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Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.