Interstitial lung disease (ILD) refers to more than 200 chronic lung disorders, including pulmonary fibrosis. With ILD, the tissue between the air sacs of the lungs (the interstitium) is affected by inflammation or scarring (fibrosis). The University of Chicago Medicine is one of only a handful of medical centers in the country that have a program dedicated to diagnosing and treating ILD.

Experts in ILD

Because most ILDs are rare, patients with these disorders need a high level of expertise. We have a dedicated, fully-staffed clinic that includes a highly specialized team of physicians who are experts in ILDs.

Our doctors will also spend time with you while getting to know you and your symptoms. When you first come to our clinic, your office visit will be about an hour long. In order to best meet your needs, subsequent visits will also be longer than traditional doctor's visits.

State-of-the-Art Diagnostics

Our physicians understand the complexity and difficulty in getting an accurate diagnosis of ILD. Since ILDs vary widely in their treatments, an accurate diagnosis is essential for you to receive the optimal treatment. Our expertise includes:

  • A list of standard lab tests that are always performed. This structured approach ensures that we check for all possible diagnoses.
  • New, high-resolution CAT scans
  • Minimally invasive diagnostic techniques — including bronchoscopy and bronchoalveolar lavage (BAL)
  • Expert thoracic surgeons for diagnostic procedures requiring surgery
  • Lab reports read by a pulmonologist and a pathologist dedicated to lung diseases
  • Pulmonary function lab considered one of the best in the state

Coordinated Care

We are committed to keeping your primary care physician in the loop regarding your treatment. Better communication with your doctor means that if you have a respiratory emergency, you can be seen by your doctor — close to home. Because we work with your doctor to plan your ongoing treatment, you continue to see your doctor for your basic medical needs, with follow-up visits to our clinic on a regular basis.

In addition, if you should need a lung transplant, you do not have to be transferred to another medical center. UChicago Medicine has one of the region's premier lung transplant programs.

We're also involved in breakthrough research. The same UChicago Medicine ILD experts you see in the clinic are also conducting research to help find better treatment options.

Interstitial lung disease (ILD) refers to more than 200 chronic lung disorders, including pulmonary fibrosis. With ILD, the tissue between the air sacs of the lungs (the interstitium) is affected by inflammation or scarring (fibrosis).

These disorders generally are:

  • Chronic (lifelong)
  • Non-malignant (not directly cancerous)
  • Non-infectious (you can't pass the disease to another person)

Fibrosis causes lung tissue to permanently lose the ability to breathe and carry oxygen. Air sacs, as well as the lung tissue between and surrounding the air sacs, and the lung's small blood vessels (capillaries), are destroyed by the formation of scar tissue.

Physicians don't know the cause of many common types of ILD, including the most common variety known as idiopathic pulmonary fibrosis. In other cases, ILD has been shown to be caused by one of the following:

  • Inhaling environmental pollutants

  • Occupational hazards, such as prolonged exposure to asbestos fibers, can cause inflammation and lead to the scarring in the lung.

  • Widespread diseases that "attack" the body, such as rheumatoid arthritis, can lead to a variety of interstitial lung diseases.

The symptoms will vary from person to person, but the most common symptoms of an ILD are:

  • Shortness of breath, especially with exertion or exercise

  • Dry cough that does not produce phlegm

  • Labored breathing

Although rapid worsening can happen, ILD's symptoms generally progress slowly and gradually get worse over time. Because these symptoms may resemble other lung conditions or medical problems, accurate diagnosis is essential to ensure proper treatment.

Usually a physician will be able to diagnose ILD using a chest X-ray or lung CT scan. But some people with ILD have a normal chest X-ray. In many cases, your doctor may ask for one or more of the following tests:

  • Pulmonary function tests (PFT): You will be asked to blow into a special machine called a spirometer, which measures whether or not you have decreased lung capacity. This test is also used to monitor ILD.

  • Exercise testing: During this test, your doctor will ask you to either ride a stationary bike or walk on a treadmill while he or she monitors your breathing and blood oxygen level.

  • Bronchoscopy: For this test, you will be awake but sedated. Your doctor will pass a flexible tube through your mouth and into your lungs. He or she will then be able to remove a very small sample of lung tissue for testing. The procedure can usually be completed in your doctor's office.

  • Open lung biopsy: Done in rare cases, an open lung biopsy requires a patient to have surgery under general anesthesia. A surgeon will make a small incision between two ribs in order to remove a small sample of lung tissue. Like most open surgeries, you will probably have to spend time in the hospital.

  • Bronchoalveolar lavage (BAL): BAL is similar to a bronchoscopy except instead of removing lung tissue, your doctor will inject and then immediately remove saline solution from your lungs. This procedure is frequently used to determine whether or not your ILD is active or non-active.

 

The course of ILD is unpredictable. Because each patient is different, your ILD may run a gradual course or a rapid course. You may notice a variation in symptoms, from very mild, to moderate, to very severe. The condition may remain the same for long periods of time or it may change quickly. At UChicago Medicine, your physician will closely monitor your ILD for change and adjust your treatment as needed.

If your ILD progresses, the lung tissue thickens and becomes stiff. Breathing then becomes more difficult and demanding. Some of the diseases improve with medication if treated when inflammation occurs. Some people may need oxygen therapy as part of their treatment.