What is ILD?
Interstitial lung diseases (ILDs) are a group of more than 200 disorders that affect the interstitium — the delicate tissue around the air sacs. Inflammation or scarring makes the lungs stiff and reduces oxygen transfer into the blood.
Some ILDs are linked to autoimmune diseases, exposures or medicines, while others, like idiopathic pulmonary fibrosis, have no known cause. Early, accurate diagnosis helps guide treatment.
Common symptoms
- Gradually worsening breathlessness on exertion
- Persistent dry cough
- Fatigue
- Clubbing of the fingertips in some patients
- Fine 'crackles' heard by the doctor at the lung bases
Possible causes & risk factors
- Autoimmune / connective tissue diseases (such as rheumatoid arthritis or systemic sclerosis)
- Hypersensitivity pneumonitis from exposure to birds, moulds or organic dusts
- Occupational exposures such as silica or asbestos
- Certain medicines and radiation therapy
- Idiopathic pulmonary fibrosis and other idiopathic interstitial pneumonias
- Sarcoidosis
When should you consult a pulmonologist?
- Breathlessness or dry cough lasting more than a few weeks
- Abnormal crackles noted on examination or an abnormal CT scan
- Joint pains, skin changes or dry eyes along with breathing symptoms
Diagnostic investigations
Your evaluation is tailored to your symptoms and history. It may include:
- High-resolution CT (HRCT) scan of the chest
- Spirometry, lung volumes and DLCO
- Six-minute walk test with oxygen monitoring
- Autoimmune blood tests
- Bronchoscopy with BAL and transbronchial biopsy in selected patients
- EBUS-TBNA when sarcoidosis is suspected
- Multidisciplinary discussion where available
Available treatment approaches
- Treatment depends on the specific type of ILD
- Removal of triggering exposures
- Anti-inflammatory or immunosuppressive medicines for inflammatory ILDs
- Anti-fibrotic medicines for progressive fibrotic ILDs
- Oxygen therapy and pulmonary rehabilitation
- Vaccinations and regular monitoring of lung function
Treatment is individualised. The options above are general information; your doctor will recommend what is appropriate for you after assessment. Outcomes vary from person to person.
Frequently asked questions
Pulmonary fibrosis refers to scarring of the lung and is one form of ILD. Not all ILDs involve permanent scarring; some are mainly inflammatory and may respond well to treatment.
