Interstitial Lung Disease
Symptoms of Interstitial Lung Disease
The most common symptom of all forms of interstitial lung disease is shortness of breath. Nearly all people with interstitial lung disease will experience breathlessness, which may get worse over time.
Other symptoms of interstitial lung disease include:
- Cough, which is usually dry and nonproductive.
- Weight loss, most often in people with COP or BOOP.
In most forms of interstitial lung disease, the shortness of breath develops slowly (over months). In interstitial pneumonias or acute interstitial pneumonitis, symptoms come on more rapidly (in hours or days).
Diagnosis of Interstitial Lung Disease
People with interstitial lung disease usually come to see a doctor due to concern about shortness of breath or cough. Imaging tests of the lungs are usually done to identify the problem.
Chest X-ray: A simple chest X-ray is the first test in the evaluation of most people with a breathing problem. Chest X-ray films in people with interstitial lung disease may show fine lines in the lungs.
Computed tomography (CT scan): A CT scanner takes multiple X-rays of the chest and a computer creates detailed images of the lungs and surrounding structures. Interstitial lung disease can usually be seen on a CT scan.
High-resolution CT scan: If interstitial lung disease is suspected, using certain CT scanner settings can improve the images of the interstitium. This increases the CT scan's ability to detect interstitial lung disease.
Pulmonary function testing: A person sits in a sealed plastic booth and breathes through a tube. People with interstitial lung disease may have a reduced total lung capacity. They may also have a decreased ability to transfer oxygen from their lungs into their blood.
Lung biopsy: Often, obtaining lung tissue to examine under a microscope is the only way to determine which type of interstitial lung disease a person has. There are several ways to collect lung tissue, which is called a lung biopsy:
- Bronchoscopy: An endoscope is advanced through the mouth or nose into the airways. Tiny tools on the endoscope can take a sample of lung tissue.
- Video-assisted thoracoscopic surgery (VATS): Using tools inserted through small incisions, a surgeon can sample multiple areas of lung tissue.
- Open lung biopsy (thoracotomy): In some cases, traditional surgery with a large incision in the chest is needed to obtain a lung biopsy.
Treatments for Interstitial Lung Disease
Treatments for interstitial lung disease vary according to the type of interstitial lung disease and its cause.
Antibiotics. These are effective treatments for most interstitial pneumonias. Azithromycin (Zithromax) and levofloxacin (Levaquin) eliminate the bacteria that cause most interstitial pneumonias. Viral pneumonias usually resolve on their own. Fungal pneumonias are rare, but can be treated with antifungal drugs.
Corticosteroids: In some forms of interstitial lung disease, ongoing inflammation in the lungs causes damage and scarring. Corticosteroids like prednisone and methylprednisolone reduce the activity of the immune system. This reduces the amount of inflammation in the lungs and the rest of the body.