Making a diagnosis of ILD and finding out the cause is done with a thorough medical history, a complete exam, a chest x-ray, breathing tests, and measurements showing the blood oxygen level at rest and with exercise. A bronchoscopy is done to check for inflammatory cells involved. A surgical lung biopsy is usually needed to make a specific diagnosis and to determine the degree of inflammation and scarring present to stage the disease. There are two components usually present - inflammation and scarring. This process is similar to the body healing a cut.
Early healing causes redness and inflammation with many activated cells surrounding the area.
Then a process of fibrosis or scarring occurs that prevents further damage, however, the elastic quality of the lungs is lost and there is tightening or stiffness that results. Treatment is targeted at reducing the inflammation in the lungs and preventing further permanent scarring. ILD can progress differently from person to person and people can respond differently to the drug therapy. This is why it is important to have a specific cause determined and to stage the disease. The Pulmonary Division of Internal Medicine has been designated as a Specialized Center of Research for pulmonary fibrosis by the National Institutes of Health, to investigate the idiopathic type.