Interstitial Lung Disease
Diagnosis of Interstitial Lung Disease continued...
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.
Esbriet (pirfenidone) and Ofev (nintedanib): These drugs are FDA-approved to treat idiopathic pulmonary fibrosis. They act on multiple pathways that may be involved in the scarring of lung tissue. Studies show both medications slow decline in patients when measured by breathing tests.
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.
Inhaled oxygen: In people with low oxygen blood levels due to interstitial lung disease, inhaled oxygen may improve symptoms. Regular use of oxygen might also protect the heart from damage caused by low oxygen levels.
Lung transplant: In advanced interstitial lung disease causing severe impairment, a lung transplant may be the best option. Most people undergoing lung transplant for interstitial lung disease make large gains in quality of life and their ability to exercise.
Azathioprine (Imuran): This drug also suppresses the immune system. It has never been proven to improve interstitial lung disease, but some studies suggest it might help.