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.
- Cough with or without sputum
- Loss of energy
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
- 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.
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.