Interstitial Lung Disease - Medical Malpractice Lawyers

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Interstitial Lung Disease - Medical Malpractice

Interstitial lung disease is an inflammation of the lung tissue that surrounds the small air sacs or alveolae within the lungs. The interstitium is the connective tissue between the air sacs of the lungs and can become scarred or damaged due to inflammation. It is generally a diffuse process that involves the entire lungs at the same time. It is sometimes referred to as "interstitial pneumonia" but is not technically a type of pneumonia. A better term would be to call it "interstitial pneumonitis" which reflects the inflammation of the lungs going on.

The main cause of interstitial lung disease is an inflammation of the lungs that is misdirected at the interstitial tissue. It can be caused by a previous infection to the lungs, toxins in the environment, including asbestos or silica dust, medications like chemotherapy given for cancer, radiation therapy to the chest area and autoimmune diseases, including lupus and rheumatoid arthritis. In some cases, there is no known cause of the interstitial lung disease and the cause is felt to be idiopathic. In general terms, it is called idiopathic pulmonary fibrosis. It is divided into four categories: 1) usual interstitial pneumonitis; 2) bronchiolitis obliterans; 3) lymphocytic interstitial pneumonitis; and 4) desquamative interstitial pneumonitis.

The main symptoms of interstitial lung disease include decreased lung capacity with stiff and effectively small lungs. You can't breathe as deeply as you need to so the oxygen level in your blood stream tends to go down. You develop shortness of breath and a dry cough that isn't productive of any kind of sputum. The lungs generally do not hurt but you can develop what's known as "clubbing" of the finger tips and congestive heart failure or an enlarged heart.

The end result is pulmonary hypertension, which is high blood pressure of the arteries of the lungs. This causes a backup of the right side of the lungs and into the body. Swelling can occur in the liver, the abdomen and the lower extremities. The end result can be respiratory failure and death or ventilator dependence.

Doctors need to use a careful history and physical examination in order to diagnose interstitial lung disease. A chest x-ray may be relatively normal or can show fine lines consistent with pulmonary fibrosis. The doctor looks for evidence of right sided heart failure. When someone comes with the set of symptoms consistent with interstitial lung disease, it can be also due to many other lung diseases so sometimes a biopsy can be done to show the pulmonary fibrosis so typical of the disease. Pulse oximetry can be done to show that the oxygen level is low and that there are pH changes in the blood stream. CT scan of the chest can show fibrosis of the entire lung, consistent with the disease.

Doctors can do pulmonary function studies to see how stiff the lungs are. The person breathes in a tube and the measurement of the total lung capacity and the ability to breathe out properly is assessed. It is usually abnormal in patients with interstitial lung disease.

A biopsy can be done of the lungs and of the airways of the lungs. It is done during a bronchoscopic evaluation of the lung. The pathologist looks at the lung tissue underneath the microscope in order to see areas of fibrosis and inflammation so common to interstitial lung disease.

Treatment of interstitial lung disease is difficult. Corticosteroids can be given to shrink the inflammation of the lung tissue. Medications that suppress the immune system such as azathioprine and cyclophosphamide also block the over exaggeration of the immune system. Both types of medication can be given at once or you can start with steroids like prednisone and then go on to the immunosuppressant drugs. Oxygen is often given and people take respiratory therapy sessions to improve the way they breathe. Patients with severe disease may need to have a lung transplant.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here