Interstitial Lung Disease (ILD) (Sarcoid, Pulmonary Fibrosis and Silicosis)

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A general category known as the interstitial lung disease includes multiple different lung conditions. All of these conditions affect the interstitium (a part of the lungs’ structure).

What is the interstitium?

It is a lace-like network of tissue that extends throughout both lungs. It is what provides support to the lungs’ microscopic air sacs. Tiny blood vessels that travel through the interstitium allow gas exchange between blood and the air in the lungs. The interstitium is normally so thin it doesn’t show up on chest X-rays or CT scans.

Thickening of the interstitium is caused by all types of interstitial lug disease. The thickening can be due to:

  • Inflammation
  • Scarring
  • Extra fluid (edema)

While some forms of interstitial lung disease are short-lived, others are chronic and irreversible.

Interstitial lung disease may be broadly categorized into known and unknown causes. Common known causes include autoimmune or rheumatologic diseases, occupational and organic exposures, medications, and radiation. Interstitial lung disease of unknown cause is predominated by idiopathic pulmonary fibrosis, a specific and progressive fibrotic lung disease, followed by the idiopathic interstitial pneumonias, such as nonspecific interstitial pneumonia (NSIP), and sarcoidosis.

 

WHAT ARE THE SYMPTOMS?

  • Dry cough
  • Shortness of breath at rest or with exertion
  • Loss of weight

 

HOW IS THIS CONDITION TREATED?

Antibiotics

This is effective for most interstitial pneumonias. Antibiotics such as Azithromycin and levofloxacin can eliminate the bacteria that cause most interstitial pneumonias. Most of the time, viral pneumonias resolve on their own. While fungal pneumonias are rare, they can be treated with antifungal drugs.

Corticosteroids

Ongoing inflammation in the lungs can cause damage and scarring in some forms of interstitial lung disease. Corticosteroids such as Rednisone and Methylprednisolone can help to reduce the activity of the immune system. The amount of inflammation in the lungs and the rest of the body are reduced.

Inhaled oxygen

People with low oxygen blood levels due to interstitial lung disease go through treatment where oxygen is inhaled to improve symptoms. The regular usage of oxygen may also protect the heart from damage caused by low oxygen levels.

 

HOW IS THIS CONDITION DIAGNOSED?

  • Chest X-ray: Normally the first test in the evaluation. Chest X-ray films may show fine lines in the lungs of people with interstitial lung disease.
  • Computed tomography (CT scan): Multiple X-rays of the chest is taken and a computer will create detailed images of the lungs and the surrounding structures.
  • High-resolution CT scan: Using certain CT scanner settings can improve the images of the interstitium. This will help to increase the CT scan’s ability to detect interstitial lung disease.
  • Pulmonary function testing: This test involves the patient sitting in a sealed plastic booth and breathing through a tube. A reduced total lung capacity may be seen in people with interstitial lung disease. A decreased in the ability to transfer oxygen from their lungs into their blood may also be seen.
  • Blood tests: Sometimes blood tests can aid in the diagnosis and or treatment of these patients. Tests for collagen vascular disease (lupus, rheumatoid arthritis), arterial blood gases, liver tests, and others may be beneficial.
  • Lung biopsy by bronchoscopy: In this procedure, your doctor removes very small tissue samples — generally no larger than the head of a pin — using a small, flexible tube (bronchoscope) that’s passed through your mouth or nose into your lungs. The serious risks of bronchoscopic biopsy include bleeding or a deflated lung, which may require treatment. More common side effects are temporary sore throat and hoarseness.

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