Interstitial Lung Diseases

This is a group of lung conditions characterized by scarring of lung tissue and consequent reduction in lung performance.

ILD is a broad term, encompassing many varied disease conditions of the lung, where the lung tissue reacts by scarring or fibrosis.

This is basically an autoimmune disease, and can be understood as being a hypersensitivity response of the body against some trigger.

Explaining the Process

When we suffer any injury on some part of the body, the affected tissue reacts by producing inflammatory reaction there. This is followed by healing process, that includes fibrosis and scarring.

Similarly, the lung tissue also reacts to the trigger, which may be an infection or injury, by producing an inflammatory process. This is followed by fibrosis and scarring. This is a normal process.

In ILD, scarring phase far exceeds the amount required. This may be called hypersensitivity. Scarring spreads throughout the lung tissue, affecting the diseased area and then the normal lung tissue also.

Scarring proceeds uninhibited and continually.

Due to scarring of the lung tissue, the functioning area of the lung involved in oxygen exchange is continuously reduced.

Symptoms

  • Breathlessness
  • Weakness
  • Cough with or without sputum
  • Loss of energy

Diagnosing ILDs

The doctor gets an idea on the basis of symptoms. All common infective processes causing cough and breathlessness are ruled out.

Investigations are performed, which include X-ray chest, followed by CT scan lungs. CT may show a picture of varying intensity, suggesting scattered tissue scarring in a portion of the lung or throughout the lung tissue.

Confirmation of diagnosis is made on lung tissue biopsy, which may be CT guided in most cases. The biopsy tissue may be taken via a bronchoscope.

Other Medical Conditions Where Lung Scarring is Seen

ILD may be a part of the following medical conditions:

  • Rheumatoid arthritis
  • Sacrcoidosis
  • SLE, Systemic Lupus Erythematosis
  • Multiple Sclerosis

It is essential to rule out the presence of any of these conditions whenever we get an ILD picture in the lung.

Treatment

Since this a hypersensitive immune response, that is, the body’s immune cells are continuously reacting in an altered way against the immune trigger, treatment constitutes medications targeting suppression of the immune response.

These may include steroid as the first line of treatment. This may be supplemented by drug like methotrexate and cyclosporin.

Medical Advice (Q&As) on “ILD Associated With Rheumatoid Arthritis

  1. Janet

    My husband had a lung CT scan which showed typical NSIP scar patterning. He then had a biopsy and was told he had UIP. He was then sent to a specialist who has told him that although UIP cannot be ruled out he could have Rheumatoid Arthritis, acid reflux, an allergy or any of several alternatives. I thought that lung biopsy results were the gold standard for diagnosing ILDs and definitive, so we are now totally confused. Please could you advise?

    Reply
    1. Buddy M.D. Post author

      Lung biopsy is definitely the gold standard. If the biopsy reported shows evidence of it, your husband does have ILD.

      However, ILDs may be associated with rheumatoid arthritis. This is because both these medical conditions are basically autoimmune in nature.

      It is suggested you go ahead with the investigations that may help diagnose rheumatoid arthritis. If the tests are positive, the treatment modalities may be different.

      Essentially, the root cause of ILD and RA is the same.

      Reply
  2. Mansour

    Dear Sir, as the doctors said I have mild lung fibrosis and it is more than 2.5 years. I have taken standard medications such as azathioprine 50-prednisolone 25-acetylcysteine 600 but without having a good result. The doctors said, since the causes of this kind of disease is not known, you have to deal with the symptoms. This matter proves what Dr Blaylock reports reveal ” Conventional medicine is NOT concerned about the underlying causes of diseases, nor about cures.’ I want to know is it correct? Or there are new researches reached to new result such as what Dr Blaylock reached for some neuro disorders in his reports. In any case, I would appreciate to advise me how can I cope with this situations. Thanking in advance. Best regards.

    Reply
    1. Buddy M.D. Post author

      Lung fibrosis belongs to a group to mysterious medical conditions. They are usually grouped under the term idiopathic, that is, cause is not known.

      However, certain trigger factors are seen to be associated with it. They include inhaling higher levels of pollutants, asbestos, silica or wastes from chemical industries. People in farming of cotton are also prone to developing this condition.

      The disease is basically autoimmune, where our immune cells over do the job alloted to them. So, in response to some minor lung injury, continuous fibrosis is triggered in the lung tissue.

      This reduces the functional area of the lung tissue, impairing its function, that is, exchange of oxygen.

      Doctors aim at suppressing this immune response. Medications given to you belong to this category. Supportive treatment to aid breathing may be given.

      You may continue with the treatment given to you. In addition, moving to a place with cleaner air (less pollution) would help.

      Patients having this condition have been seen to benefit from deep breathing exercises, especially when started in early stages.

      Reply