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Interstitial Lung Disease

Interstitial Lung Disease

Definition

Interstitial lung disease (ILD) is a group of disorders that leads to scarring, called fibrosis, in the lung tissue. It affects the space around the small air sacs of the lung.

All ILD disorders affect this particular area of the lung. However, the progression of diseases and the other parts of the lungs that may be affected are unique to each disorder.

Causes

Injury or illness can cause inflammation in the lungs and airways. Inflammation stimulates a process to rebuild injured tissue. With ILD, this inflammation and tissue building does not stop. Over time, the excess tissue building leads to fibrosis in the lungs. The fibrosis makes it difficult for oxygen to pass from the lung tissue to the blood vessels in the lungs. This decreases the amount of oxygen available to the body.

The inflammation and tissue building process may begin or go unchecked because of:

  • Lung diseases or infections
  • Long-term exposure to irritants such as dust, gasses, or fumes from industry or agriculture
  • Autoimmune diseases
  • Certain medications, such as:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Chemotherapy
    • Medications that change or suppress the immune system
  • Genetic abnormalities

Sometimes, the exact reason for the abnormal tissue building process is unknown.

Normal Gas Exchange in the Lungs
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Copyright © Nucleus Medical Media, Inc.

Risk Factors

The risk of ILD increases with age. Other factors that may increase your chance of ILD include:

  • Having a lung disease that causes fibrosis, such as idiopathic pulmonary fibrosis
  • Having an autoimmune disorder, such as rheumatoid arthritis or scleroderma
  • Working in occupations where you inhale dust, fibers, fumes, or bird droppings
  • Smoking
  • Family history or genetics
  • Long-term medication use
  • Cancer treatment—radiation and/or chemotherapy can damage lung tissue

Symptoms

The most common symptom of ILD is shortness of breath that worsens with time. Breathing problems occur with activity and at rest.

ILD may also cause:

  • Persistent, dry cough that cannot be controlled
  • Fatigue
  • Clubbing—nails that bulge or thicken

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done. Your doctor may suspect ILD based on this information.

To determine how well your lungs are working, your doctor may do the following tests:

  • Blood tests
  • Pulse oximetry—to measure the amount of oxygen in the blood

To confirm a diagnosis or determine the reason for scarring, a tissue sample may be removed from the lungs and closely examined. Images of the lungs and chest cavity may also be taken with:

  • Chest x-ray
  • CT scan
  • Echocardiogram

If you are diagnosed with ILD, pulmonary function tests can help determine how much your breathing is affected.

Pulmonary Function Tests—Peak Flow Meter
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Copyright © Nucleus Medical Media, Inc.

Treatment

Treatment depends on the cause of ILD. The goal of treatment is to slow progression of the disease. Damage to the lungs is permanent and cannot be reversed, but treatment will help to ease symptoms and improve quality of life.

Treatment will be based on your specific condition and symptoms. General approaches include:

Prevention

Not all ILDs can be prevented. To help reduce your exposure to substances associated with some ILDs:

  • Talk to your doctor about ways to help you quit smoking.
  • Avoid lung irritants whenever possible.
  • Follow occupational guidelines to protect your lungs at work.
  • Use proper protection when exposed to harmful chemicals, dust, or animal droppings.
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