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Interstitial Lung Disease (ILD) / Lung Fibrosis

Interstitial Lung Disease (ILD) refers to a group of over 200 lung disorders that cause inflammation and scarring of the interstitium – the tissue around the lung’s air sacs. This scarring makes the lungs stiff and reduces their ability to expand properly, leading to breathlessness, chronic dry cough and reduced oxygen levels in the blood. Over time, fibrosis can get worse, turning ILD into a progressive and potentially life threatening disease if not managed early.

Types of ILD:

Hypersensitive Pneumonitis (HP): It is caused by repeated inhalation of allergens such as mold, bird droppings, or dust from farms. HP triggers immune inflammation in the lungs.
Connective tissue disease – related ILD: It is seen in patients with autoimmune diseases like Rheumatoid Arthritis, Systemic Sclerosis, Lupus, or Myositis. The immune system attacks the lung tissue, causing inflammation and fibrosis.
Idiopathic Pulmonary Fibrosis: A specific type of ILD where the cause is unknown. It is progressive and irreversible, commonly affecting men over 50. IPF has a poorer prognosis if not treated with antifibrotics.

Symptoms of ILD

Persistent dry cough
Shortness of breath during exertion (later even in rest)
Fatigue and weakness
Unintentional weight loss
Finger clubbing
In some cases: chest discomfort or tightness

Causes of ILD

Autoimmune diseases (CTD – ILD)
Inhaled allergens or irritants (dust, birds, mold – HP)
Genetics or family history
Smoking
Certain medications (amiodarone, methotrexate)
Chronic infections or radiation therapy
Unknown cause (IPF)

Diagnosis

It can be diagnosed through:

High – resolution CT (HRCT) chest scan.
Pulmonary function test (PFT) – it shows the restrictive pattern
Blood tests for autoimmune markers
Bronchoscopy for lung biopsy

Treatment for ILD

Steroids and immunosuppressants for inflammatory types like CTD – ILD, HP
Antifibrotic drugs like pirfenidone and nintedanib
Oxygen therapy
Pulmonary rehabilitation
Avoiding allergen exposure in HP
Lung transplant in advance cases

Frequently Asked Questions (FAQs)

1. Is ILD curable?

No, but it is manageable. Early treatment can slow or stabilize the disease, especially in inflammatory types. IPF is progressive but antifibrotics can slow its progression.

2. Are ILD’s always progressive?

Not always, in reversible types like early HP or CTD – ILD, fibrosis can stabilize or slightly improve. IPF, however, tends to progress overtime.

3. Can ILD be caused by allergies?

Yes, hypersensitivity pneumonitis, a type of ILD is caused by the long – term exposure to airborne allergens like mold or bird droppings.

4. Is ILD the same as COPD or asthma?

No, ILD affects the lung tissue, while COPD and asthma affect the airways and usually have wheezing and mucus, their treatment and prognosis is also different.