Dr. Sheetu Singh is a woman of dynamic personality with a noble heart. Comfort care and quality cure are the primary concern for her and this comes with trust that she gained from her clients. Being Ild Specialist in Jaipur Rajasthan India she has various equipments to cure this deadly disease.
What is ILD?
Interstitial lung disease (ILD) is a group of disease in which the lungs get shrunken due to multiple causes. The symptoms of ILD are cough without sputum and difficulty in breathing while walking or exercise.
What causes ILD?
ILD is of different types the common ones are: hypersensitivity pneumonitis (HP), connective tissue associated ILD, idiopathic pulmonary fibrosis (IPF) and sarcoidosis.
HP is the most common type of ILD and is caused due to exposure to birds such as pigeons, parrots, hen, molds on wall, leaky airconditioners and aircoolers with dirty old mats.
Connective tissue disease associated ILD is due to disease such as rheumatoid arthritis, scleroderma and sjogren’s syndrome.
The cause of IPF is unknown. However it is seen in elderly men who have history of smoking.
Sarcoidosis also the cause is not known. Though, its association with tuberculosis has been shown in studies.
What are the symptoms of ILD?
- Difficulty in breathing: on walking, climbing stairs and exercise
- Cough with minimal sputum: sometimes cough is very distressing
- Chest pain
- Joint pains – in patients with sarcoidosis and connective tissue associated ILD
- Raynaud’s phenomenon – fingers turn blue on exposure to cold. This happens in patients with scleroderma associated ILD
How to diagnose ILD?
Chest x ray, spirometry and six minute walk test provide clues that patient may be having ILD. Confirmation is done with the help of special type of CT scan called as HRCT.
Further classification in various types of ILD requires a battery of tests which include
- Serum collagen profile: helps differentiate connective tissue associated ILD
- Serum IgG for birds: helps detect bird exposure in cases of HP
- Bronchoscopy and transbronchial lung biopsy: may be planned to take a piece of lung for examination
- EBUS TBNA: this is a specialized type of bronchoscopy which takes samples from the lymph nodes in patients with sarcoidosis
How to treat ILD?
There are 2 types of ILD –
- Steroid responsive: especially in cases of HP, connective tissue associated ILD and sarcoidosis. These diseases have good response to steroids. Certain steroid sparing agents may be used called as immunosuppressive agents. These help in bringing down the medication dose. Immunosuppresives drugs include azathioprine, mycophenolate mofetil and cyclophosphamide.
- Steroid unresponsive: IPF is a disease which does not respond to steroids. The recommended drugs are Pirfenidone and Nintedanib.
How to check treatment response?
Spirometry, diffusion study and six minute walk test are simple and easy test to check for treatment response. CT scan is repeated only after 1-2 years.