Interstitial Lung Disease

Understanding Interstitial Lung Disease (ILD)

Interstitial Lung Disease (ILD) refers to a group of over 200 chronic lung disorders that cause inflammation and scarring (fibrosis) of the interstitium, the tissue surrounding the lung’s air sacs. This scarring can make it difficult for oxygen to pass into the bloodstream, leading to various respiratory symptoms. ILD is a significant health concern in Australia, with an estimated prevalence of approximately 2.7 per 10,000 people, though this number may be higher due to underdiagnosis.

Symptoms of Interstitial Lung Disease

Symptoms of ILD can vary depending on the specific type of disease, but common signs include:

• Shortness of breath: Initially noticed during physical exertion but can progress to occur even at rest.
• Dry cough: Persistent and not typically accompanied by mucus.
• Fatigue: Due to reduced oxygen supply to the body.
• Chest discomfort: A feeling of tightness or pain.
• Unexplained weight loss: A possible sign of advanced disease.
• Clubbing of fingers: Swelling and rounding of the fingertips may occur in some cases.

Causes of Interstitial Lung Disease

The exact cause of ILD is often unknown (idiopathic), but various factors may contribute, including:

• Environmental exposures: Prolonged contact with pollutants like asbestos, silica dust, or mould.
• Occupational risks: Jobs in mining, farming, or construction.
• Autoimmune conditions: Diseases such as rheumatoid arthritis or systemic lupus erythematosus.
• Medications: Long-term use of certain drugs, such as chemotherapy agents or antibiotics, may increase risk.
• Smoking: A significant contributing factor.
• Idiopathic: Unknown cause.

Diagnostic Tests

Accurate diagnosis of ILD is essential for effective management. At Manse Medical, our diagnostic approach includes:

1. Pulmonary function tests (PFTs): Assess lung capacity and airflow.
2. High-resolution computed tomography (HRCT): Provides detailed imaging of lung tissue to identify scarring and inflammation.
3. Bronchoscopy: A minimally invasive procedure to collect lung tissue or fluid samples.
4. Blood tests: Identify underlying autoimmune conditions or infections.
5. Lung biopsy: Occasionally needed to confirm the type of ILD.

Complications of ILD

If untreated, ILD can lead to:

• Respiratory failure: Due to inadequate oxygenation.
• Pulmonary hypertension: Increased blood pressure in the lungs’ arteries.
• Heart failure: Strain on the heart from reduced lung function.
• Acute exacerbations: Sudden worsening of symptoms, requiring urgent medical care.

Treatment Options

While there is no cure for most forms of ILD, treatments aim to manage symptoms, slow disease progression, and improve quality of life:

• Medications:
  • Anti-inflammatory drugs: Steroids to reduce inflammation.
  • Antifibrotic agents: Drugs like pirfenidone and nintedanib to slow scarring.
• Oxygen therapy: Eases breathing difficulties and improves energy levels.
• Pulmonary rehabilitation: Exercises and education to enhance lung function and overall health.
• Lifestyle changes: Smoking cessation and avoiding environmental triggers.
• Lung transplantation: Considered for advanced cases where other treatments are ineffective.

Frequently Asked Questions (FAQs)