Interstitial Lung Disease

Interstitial lung disease is a term that encompasses several diseases, but the common thread between them is severe scarring in the lungs due to inflammation. This inflammation in the lungs can be caused by a number of environmental factors such as asbestos exposure, silica dust, cotton dust, coal dust, and hard metal dust.

Interstitial lung disease affects bronchioles, which are the small airways in the lungs. These bronchioles develop clusters of air sacs, which are called alveoli. As the disease worsens and the alveoli become thicker, they also begin to lose their elasticity. Then, gradually, these air sacs lose their capability to put oxygen in the blood and remove carbon dioxide.  The most common symptoms of interstitial lung disease are shortness of breath, increased fatigue during exertion, coughing, and chest pains.

Diagnosis

The diagnosis of interstitial lung disease can often be difficult because the symptoms are very similar to other lung conditions and diseases. The diagnosis of this lung disease requires tests such as x-rays, CT scans, and pulmonary function tests. The chest x-rays are used to test for and rule out conditions like a collapsed lung and emphysema. But x-rays alone cannot detect interstitial lung disease. CT scans show highly detailed images of the lungs through computerized technology. Pulmonary function tests may also be needed for diagnosis. These tests can involve a biopsy of the lungs, where a tiny tissue sample is taken from the lungs to determine the condition of the lung.

Treatment

The treatment of interstitial lung disease is directed towards relieving symptoms and prevention of complications such as heart disease and high blood pressure. Oxygen may be a treatment option for patients with shortness of breath. Anti-inflammatory medications are commonly prescribed to patients with interstitial lung disease as well. In severe cases where the lungs are extremely damaged, a lung transplant might be recommended.

The complications of interstitial lung disease may be life threatening. Pulmonary hypertension, which is high blood pressure in the lungs, is a serious issue with this disease. Medications such as blood thinners may be helpful. Pleural plaques and pleural effusions may also occur in patients with asbestos exposure.  If the disease is detected and treated early on, it may not lead to severe complications. It all depends on the patient’s physical condition, environmental factors, and predisposing factors like smoking.

Asbestos and ILD

Asbestos can be a contributing factor to interstitial lung disease, which may itself be a precursor of asbestosis.  A Yugoslavian study of six non-smoking asbestos exposure patients showed that interstitial lung disease could be detected early through tests of the flow rate of air through bronchioles and high resolution CT scans.

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