What Is Interstitial Lung Disease (ILD)?
ILD is not a single disease—it refers to more than 200 lung disorders that affect the tissues supporting the air sacs of the lungs. As fibrosis develops, lungs lose elasticity, making breathing increasingly difficult.
Some forms of ILD progress slowly, while others worsen rapidly and can become life-threatening. Early consultation and timely follow-ups are crucial to decide, evaluate and modify treatment strategies.
Common Symptoms of ILD
Symptoms usually develop gradually, which is why many patients in India present late.
"If these symptoms persist for more than 2-3 weeks, early evaluation by a Pulmonologist is essential.."
What Causes & Risk Factors of ILD
ILD can develop due to multiple causes. Some of these are preventable and others not.
Environmental & Occupational Exposures
Hypersensitivity Pneumonitis: One large registry in India reported that this is the most common ILD in Indian practice but this is predominantly reported from Western India
Autoimmune & Connective Tissue Diseases
is one of the most common causes of ILD in South India
These conditions can cause progressive lung fibrosis to the extent of needing transplantation.
Occupational Exposures:
Common in India due to industrial and agricultural settings
Medications & Radiation Therapy:
Certain antibiotics, chemotherapy and heart anti-arrhythmic medications
Smoking:
70% of patients with IPF having smoking exposure and smoking is also related to other types of ILD, including RB-ILD, Alveolar macrophage pneumonia, and smoking-related interstitial fibrosis
Familial causes:
About 3-10% of all ILDs are familial and these are due to mutations in several genes that affect telomere maintenance.
Unknown Cause (Idiopathic)
Idiopathic Pulmonary Fibrosis (IPF):
is one of the most common and serious ILDs. It is an abnormal wound healing of an aging lung to cumulative lifetime lung exposures. 70% have a prior history of smoking and others report occupational exposures. This is typically seen in those above 60 years and is almost always progressive. Idiopathic NSIP, LIP and PPFE are other rarer types of ILD
How is ILD Diagnosed?
Diagnosis requires a comprehensive and systematic approach for causes, which can be hidden. Often ILDs can mimic asthma, COPD, or infections and may be misdiagnosed, leading to crucial delay in treatment with irreversible loss of lung function.
Diagnostic Tests Include:
Accurate classification of ILD is essential for choosing the right treatment
Progress needs to be monitored periodically with lung function tests and 6MWT. This may be repeated every 3-4 months in the first year and every 6 months if clinically stable. CT scans are repeated if there is a concern for worsening.
Treatment Options for ILD:
The main aim of treatment is to limit the extent of scarring and reverse any reversible lung injury. Lung scarring (fibrosis) cannot be reversed, but fibrosis often worsens over time and treatment to slow worsening fibrosis may be used. Treatment focuses on:
Treatment May Include:
Lung transplantation in worsening disease despite optimal therapy, early referral for lung transplantation is the only way to improve survival. Lung Transplant must only be offered in centers with at least 80% 1-year survival and 70% 3-year survival. The survival of advanced or end-stage disease is poor with <50% 2-year survival. Transplant also improves quality of life markedly with patients able to return to normal life and work by 3-4 months after lung transplantation. At Apollo Chennai, our program offers outcomes superior to the above international outcomes
India sees a high burden of ILD due to:
Dr. Srinivas Rajagopala provides expert evaluation and long-term management of Interstitial Lung Disease in India, following international guidelines while addressing region-specific risk factors.
When Should You Consult an ILD Specialist in India?
Seek expert care if you:
Early specialist involvement can significantly impact outcomes. Timely diagnosis and expert care can slow ILD progression and improve survival and quality of life. The ILD clinic at Apollo Teynampet headed by Dr Srinivas Rajagopala is integrated with lung transplant program and automatically provides this option in the event of decline despite optimal treatment.
