This book describes Interstitial Lung Disease, Diagnosis and Treatment and Related Diseases
Interstitial lung disease (ILD) is a collection of lung disorders in which the lung tissues become inflamed and then injured.
All interstitial lung diseases involve the interstitium, a part of the lungs' anatomical structure.
The interstitium is a lace-like system of tissue that extends throughout both lungs that gives support to the lungs' microscopic air sacs (alveoli).
Normally, the interstitium is so thin it cannot be observed on chest X-rays or CT scans.
Types of Interstitial Lung Disease
All types of interstitial lung disease induce thickening of the interstitium.
The thickening can be because of inflammation, scarring or extra fluid (edema).
Some types of interstitial lung disease are short-lived; others are chronic and irreversible
1. Interstitial pneumonia: Bacteria, viruses, or fungi may cause infection of the interstitium
2. Idiopathic pulmonary fibrosis (IPF): a chronic, progressive form of scarring of the interstitium.
Its cause is not known, which is why it is called idiopathic.
3. Nonspecific interstitial pneumonitis: caused by autoimmune disorders (such as rheumatoid arthritis or scleroderma).
4. Hypersensitivity pneumonitis (HP): caused by continual inhalation of dust, mold or other irritants.
5. Cryptogenic organizing pneumonia (COP): a pneumonia-like interstitial lung disease but without an infection present.
6. Acute interstitial pneumonitis: a sudden, severe interstitial lung disease, often needing life support.
7. Desquamative interstitial pneumonitis: an interstitial lung disease that is partially caused by smoking.
8. Sarcoidosis: a disorder causing interstitial lung disease along with swollen lymph nodes, and occasionally heart, skin, nerve, or eye involvement.
9. Asbestosis: an interstitial lung disease produced by asbestos exposure.
Symptoms
Shortness of breath is a major symptom of ILD
Other symptoms are:
1. Cough, which is normally dry and nonproductive
2. Weight loss, most often in patients with COP
3. In most types of interstitial lung disease, the shortness of breath forms slowly
In interstitial pneumonias or acute interstitial pneumonitis, symptoms happen more rapidly (in hours or days).
4. Overtime, weight loss, fatigue, and muscle and joint pain
People with more advanced ILD may have:
1. Abnormal enlargement of the base of the fingernails (clubbing)
2. Blue color of the lips, skin, or fingernails because of low blood oxygen levels (cyanosis)
3. Symptoms of the diseases such as arthritis or trouble swallowing
Diagnosis
A simple chest X-ray is the first test in the appraisal of most people with a breathing problem
High-resolution CT scan can provide the best images of the chest
Lung biopsy confirms diagnosis
Treatment
The treatment is dependent on the cause and duration of the disease.
1. Antibiotics

These are effectual treatments for most interstitial pneumonias

a. Azithromycin and levofloxacin remove the bacteria that produce most interstitial pneumonias.
b. Viral pneumonias normally recover by themselves.
c. Fungal pneumonias with antifungals
2. Corticosteroids like prednisone decrease the action of the immune system
3. Azathioprine, Pirfenidone and N-acetylcysteine can slow down the disease by suppressing the immune system
4. Regular usage of oxygen might also defend the heart from injury
5. Lung transplant: In advanced interstitial lung disease producing severe impairment, a lung transplant may be the best...