Pulmonary, Critical Care & Sleep Medicine

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Interstitial Lung Disease

Numerous conditions make up the group of disorders called ILD. Most of those disorders cause progressive scarring of the lung tissue that eventually affects your ability to breathe and get enough oxygen into your blood stream, but beyond this the disorders vary greatly. Although most cases of interstitial lung disease develop gradually, a few come on suddenly. Doctors can pinpoint why some cases of interstitial lung disease occur, but many have no known cause. In all cases, lung scarring, once it occurs, is generally irreversible. Medications occasionally can slow the damage of interstitial lung disease, but many people never regain full use of their lungs.

Symptoms of Interstitial Lung Disease

Despite the wide variety of disorders classified as interstitial lung disease, the signs and symptoms are often similar, including:

A feeling of breathlessness (dyspnea), especially during or after physical activities
A dry cough

Because these problems are vague and tend to develop gradually — often long after you have irreversible lung damage — you may attribute them to aging, to being overweight or out of shape, or to the residual effects of respiratory infection.
Symptoms tend to become progressively worse, however, and eventually you may notice you're getting out of breath during routine activities — getting dressed, talking on the phone, even eating. Other, far less common signs and symptoms include wheezing, chest pain and clubbing of the fingers, a physical sign that occurs when your fingertips painlessly enlarge and the nails curve over the tops of your fingertips.

How is ILD Diagnosed

Doctors normally begin by taking a comprehensive medical history, focusing especially on occupational exposure to lung-damaging toxins, on medications and on the presence of health problems commonly associated with lung disorders.
But although a medical history and physical exam can be useful in ruling out certain conditions, they can't accurately diagnose interstitial lung disease. Instead, doctors utilize other tests such as:

Chest X-ray
CT scan of the chest
Pulmonary function tests (PFTs)
Exercise tests
Bronchoscopy with transbronchial biopsy and bronchoalveolar lavage
Video-assisted thoracoscopic surgery (surgical lung biopsy)

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Page Updated 09/23/2014