Interstitial Lung Disease

• Interstitial lung disease (ILD) is a broad term for a collection of over 150 disorders that inflame or scar the lungs, leading to pulmonary fibrosis
• May be an acute or chronic process
• Associated with infection, exposure to dust or other particles, or an underlying genetic predisposition

The cause may also be unknown (idiopathic interstitial pneumonias).

DIFFERENTIATING BETWEEN THE VARIOUS ILDs IS CHALLENGING

• ILDs have similar symptoms, physiology, and features on thoracic imaging¹
• Diagnosis is improved by multidisciplinary discussion among pulmonologists, radiologists, and pathologists²
• Successful management of a patient with ILD depends on an accurate diagnosis, allowing physicians to:¹
  • Provide patients with appropriate prognostic information
  • Develop a management strategy with the patient

INTERSTITIAL LUNG DISEASES ARE A DIVERSE GROUP OF CONDITIONS THAT CAUSE LUNG FIBROSIS¹

150+ ILDs

Many ILDs share similar symptoms, physiology, and radiologic findings.¹

ILDs ARE OFTEN CHARACTERIZED BY DYSPNEA AND COUGH¹

• Signs and symptoms shared by most ILDs include:^3-7
  • Dyspnea
  • Cough
  • Fatigue
  • Restrictive pattern on PFTs^a
  • Diffuse lung infiltration on chest imaging

SIGNS AND SYMPTOMS OF ILDs MAY BE MISTAKEN FOR MORE COMMON DISORDERS^6,8

ILDs may be mistaken for more common disorders, such as:^6,8

• Pulmonary: Bronchitis, pneumonia, chronic obstructive pulmonary disease (COPD), asthma
• Cardiac: Congestive heart failure (CHF), cardiac ischemia
• Psychogenic conditions

ILD MISDIAGNOSIS AFFECTS PATIENT CARE AS WELL AS QUALITY OF LIFE⁶

In one survey of patients with ILD, 55% of respondents had at least 1 misdiagnosis and 38% had 2 or more misdiagnoses.

75% consulted 3 or more physicians

• 68% of respondents stated that consulting a specialist with expertise in ILD was the most important factor in obtaining an accurate diagnosis

34% had a delay of 2 or more years in diagnosis

• Misdiagnosis affected amount of time spent with friends and family, and some patients reported that it influenced their decision to retire or apply for disability

ILDs ARE CLASSIFIED BY THE ORIGINATING FACTOR⁹

ILDs often share dyspnea and cough as presenting symptoms, but in the cases where there is an underlying associated disease they will also produce additional signs and symptoms.¹

PROGRESSION AND SURVIVAL VARIES BASED ON THE TYPE OF ILD

• Many ILDs have high rates of morbidity and mortality⁷
• ILDs are commonly observed in patients of all ages, but more frequently affect adults⁷
• Most unretired patients with ILD are unable to work due to breathlessness upon exertion⁵
• Patients with occupational or exposure-related ILD should avoid further exposure and transfer to another job⁵