Interstitial lung disease is a group of lung diseases characterized by the growth of scar tissue or fibrosis in the lungs . Symptoms of this disease include dry cough and shortness of breath that can worsen over time.
Interstitial lung disease causes thickening of the interstitial tissue, which is the tissue around the alveoli (air sacs in the lungs). This condition causes lung tissue elasticity to decrease and lung capacity to decrease. As a result, respiratory function decreases and the supply of oxygen in the blood decreases.
Causes of Interstitial Lung Disease
Interstitial lung disease or interstitial lung disease occurs as a result of injury to the lungs. The injury triggers a wrong response from the body in the form of scar tissue formation in the lungs.
Some of the conditions that can cause injury to the lungs and trigger a wrong response from the body are:
Various autoimmune diseases can trigger the appearance of interstitial lung disease, including:
- Dermatomyositis and polymyositis
- Rheumatoid arthritis
- Sjogren's syndrome
Drug side effects
Some types of drugs that can cause lung damage and trigger the appearance of interstitial lung disease are:
- Chemotherapy drugs and immunomodulators, such as methotrexate and cyclophosphamide
- Heart disease medications, such as amiodarone and propanolol
- Antibiotics, such as nitrofurantoin and ethambutol
- Immunosuppressant drugs , such as rituximab or sulfasalazine
Display of hazardous m aterial
Workers in mining, agriculture, or construction are often exposed to chemicals that are harmful to the lungs, putting them at high risk of interstitial lung disease. Examples of such hazardous materials are asbestos fibers, coal dust, bran, fungal and mold spores, silica dust, and bird droppings.
In addition to the trigger factors that have been mentioned above, there are also factors that can increase a person's risk of getting interstitial lung disease, among others:
- Mature age
- Having a family history of interstitial lung disease
- Have undergone radiotherapy or chemotherapy
- Has a smoking habit
- Suffering from acid reflux disease (GERD)
Even so, there are several types of interstitial lung disease whose cause has not been known until now.
There are various types of interstitial lung disease, namely:
- Interstitial pneumonia
- Idiopathic pulmonary fibrosis
- Nonspecific interstitial pneumonitis
- Hypersensitivity pneumonitis
- Cryptogenic organizing pneumonia (COP)
- Desquamative interstitial pneumonia
Symptoms of Interstitial Lung Disease
Symptoms of interstitial lung disease appear when damage to the interstitial tissue has affected the respiratory system. Symptoms that appear in patients with interstitial lung disease are dry cough that can worsen during activity.
Over time, other symptoms also appear, including fatigue, muscle and joint pain, weight loss, fever, and shortness of breath . These symptoms can continue to worsen over time.
In patients with end-stage interstitial lung disease , more serious symptoms and signs can be seen related to a decrease in oxygen levels in the blood, namely:
- Bluishness in the lips, skin, and nails
- Widening the shape of the fingertip ( clubbing finger )
- Enlargement of the heart
When should you go to the doctor?
Check with a doctor as soon as possible when suffering from prolonged and worsening dry cough. These symptoms are common in various lung diseases. Therefore, early examination is needed to detect the type of disease so that the right treatment can be given immediately.
Interstitial lung disease is a long-lasting disease (chronic) so routine check-ups with the doctor are required to monitor the progress of the disease and prevent complications.
Interstitial lung disease can be caused by rheumatoid arthritis or side effects of amiodarone. If you suffer from rheumatoid arthritis or consume amiodarone in the long term, do routine check-ups with your doctor to monitor the progress of the disease and evaluate the treatment.
Interstitial lung disease can also appear as a result of exposure to asbestos particles. For employees who are at risk of being exposed to asbestos, conduct employee medical check-ups periodically according to company policy. In addition, comply with company rules related to work safety, to prevent diseases caused by exposure to asbestos.
Diagnosis of Interstitial Lung Disease
Symptoms of interstitial lung disease are commonly found in various other respiratory diseases. As a result, the process of diagnosing this disease becomes quite difficult.
Therefore, the doctor will check the possibility of factors that can trigger interstitial lung disease. Through questions and answers, the doctor will go over the symptoms, health history, as well as the patient's occupation and habits.
After that, the doctor will perform a physical examination with a stethoscope, to listen to the patient's breathing.
In addition to tracing the symptoms and checking the physical condition of the patient, the doctor also needs to perform a supporting examination to determine the diagnosis of this disease. The examination is in the form of:
The lung scanning methods used to detect interstitial lung disease are chest X- rays and CT scans.
Lung function test
This test aims to measure lung performance with a special examination called spirometry .
Biopsy of lung tissue
This examination is performed to see the lung tissue sample in more detail through observation under a microscope. Lung tissue samples can be taken through a bronchoscopy procedure . This procedure uses a small tube with a camera inserted through the mouth or nose.
Treatment of Interstitial Lung Disease
The treatment of interstitial lung disease or interstitial lung disease aims to relieve symptoms, slow down the progression of the disease, and maintain the patient's quality of life. One of the methods is by giving the drugs below:
Corticosteroids are used to inhibit the activity of the immune system so that the body's response that causes inflammation and damage to the lung organs can be suppressed.
drugs Antifibrosis drugs are given to patients with pulmonary fibrosis Examples of drugs in this group are pirfenidone or nintedanib.
Antibiotics and antifungals
Antibiotics are given to patients with interstitial pneumonia caused by bacterial infection. While antifungals are given to patients with interstitial pneumonia caused by a fungal infection.
Drugs that reduce the production of stomach
acid Symptoms of increased stomach acid can worsen the symptoms of interstitial lung disease . To reduce the production of stomach acid, the doctor can give proton pump inhibitors or H2 antagonists.
In addition to the administration of drugs, there are other methods that can also be used in the treatment of interstitial lung disease, namely:
Giving supplemental oxygen Giving supplemental oxygen aims to increase the insufficient supply of oxygen to the patient's body.
program Lung rehabilitation program aims to make the lungs work more effectively. This program includes physical training and breathing technique training, as well as emotional support and nutritional guidance.
transplantation Lung transplantation is the last treatment step for patients with interstitial lung disease. This method is performed if other treatments cannot alleviate the symptoms and cannot improve the patient's quality of life.
Be aware that not all lung tissue damage in interstitial lung disease can be cured. The treatment given is also not always successful. In other words, recovery depends on the type and severity of the disease, as well as the condition of the sufferer.
Complications of Interstitial Lung Disease
Interstitial lung disease can cause complications for sufferers, including:
- Pulmonary hypertension
- Pulmonary embolism
- Lung cancer
- Coronary heart disease
- Heart failure
- short of breath
Prevention of Interstitial Lung Disease
Not all types of interstitial lung disease can be prevented, for example in the type whose cause is not yet known. Preventive measures that can be taken according to the trigger factors and risk factors, among others:
- Use personal protective equipment at work to avoid exposure to hazardous particles at work
- Quit smoking to protect the lungs from any type of disease, including interstitial lung disease
- Getting vaccinations, such as the flu and pneumonia vaccine, to protect the lungs from infections that can trigger interstitial lung disease