ILD Screening, Diagnosis & Treatment

What is ILD?

Interstitial lung disease (ILD) is a category of lung disorders characterized by inflammation and/or scarring of lung tissue. Such damage can affect your ability to breathe and to get adequate oxygen into the blood stream.

Causes of ILD

Many factors may cause interstitial lung disease (ILD), including the following:

  • Autoimmune diseases, including rheumatoid arthritis, scleroderma, and dermatomyositis
  • Certain medications, including sulfonamides, nitrofurantoin, bleomycin, and methotrexate
  • Exposure to environmental hazards, including coal dust, asbestos, silica dust, and cotton dust
  • Chronic exposure to organic substances such as bird droppings or molds
  • Radiation therapy that is delivered to the chest
  • Genetic factors or predisposition

For cases in which the cause of ILD is unknown, the condition is referred to as idiopathic ILD.

Symptoms of ILD

The most common symptoms of ILD are:

  • Shortness of breath that may worsen over time
  • Dry cough
  • Weight loss, joint and muscle pain, and fatigue

Common Comorbidities

Comorbidities (diseases or conditions that exist at the same time) that are most likely to occur with chronic ILD include:

  • Deconditioning (loss of muscle tone)
  • Gastro esophageal reflux disease (GERD
  • Obstructive sleep apnea (OSA)
  • Sleep disorder breathing
  • Pulmonary embolism
  • Psychiatric stress and depression
  • Osteoporosis
  • Coronary artery disease
  • Pulmonary hypertension

Screening & Diagnosis

To diagnose ILD, your doctor will take your thorough medical history and perform a physical exam, looking for the signs and symptoms of interstitial lung disease such as rales, (sounds heard with the stethoscope) and clubbing of the fingers.

Additional diagnostic tests may include:

  • Pulmonary function tests (including 6 minute walk test)
  • Blood tests (to look for connective tissue diseases and other disorders)
  • CT scan of the chest
  • Bronchoscopy and/or lung lavage
  • Echocardiogram
  • And possibly surgical lung biopsy

ILD Treatments

Our goal is to improve the overall quality of your life by resolving inflammation, and reversing or slowing the rate of ILD progression. Depending on the specific cause and progression of your diseases, treatment may include:  

  • Medications
    • Corticosteroids (prednisone)
    • Immunosuppressive therapy
    • Immunomodulator therapies
    • Antioxidants
    • Antibody treatment
    • Antifibrotic therapy (expected availability)
    • Other such as intravenous immunoglobulin treatment
  • Pulmonary rehabilitation
  • Oxygen therapy
  • Treatment for the comorbidities may be used as needed
    • Continuous positive airway pressure (CPAP) for obstructive sleep apnea
    • Medications for reflux
    • Medications for pulmonary hypertension
  • Surgery
    • Patients suffering from advanced ILD may also be referred for lung transplantation
  • Palliative/supportive care

Because ILD can commonly involve comorbidities (including obstructive sleep apnea, pulmonary embolism, osteoporosis, and pulmonary hypertension), our pulmonologists work closely with other specialists throughout the Mount Sinai Health System to provide the most comprehensive care to our patients.

Our program is also involved in patient education about living with ILD. We have research site for clinical trials that study new treatments, and we provide access to patients interested in participating.