Clinical profile of interstitial lung disease at a tertiary care centre, India
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Department of Pulmonary Medicine, TNMC & BYL Nair Hospital, Mumbai, India
Jyotsna M. Joshi   

Department of Pulmonary Medicine, 2nd floor, OPD bldg, TNMC & BYL Nair Hospital, AL Nair Road, Mumbai Central, Mumbai 400008; India
Pneumon 2017;30(1):17–23
Interstitial lung diseases (ILD) are a complex group of disorders. As of date, the data on ILD is mostly from the western world with scarce Indian studies. Hence, we decided to study the clinical profile of the interstitial lung disease patients at our institute.

A prospective observational study was conducted at a tertiary care centre over 3 years. The study was an independent subset analysis of the patients enrolled in the national ILD-India registry. Adult ILD patients diagnosed with multi-disciplinary diagnosis were included. Patients were managed as per guidelines. Follow-up was noted wherever available. Statistical analysis was done with frequency, mean, standard deviation and percentages.

One hundred and forty ILD patients were included. There was a male predominance. Average age was 53.99 years. Most common symptoms were dry cough and exertional dyspnea. Examination revealed end inspiratory velcro crackles and digital clubbing. Average partial pressure of oxygen, forced vital capacity, diffusion of lung for carbon monoxide was 73.22 mmHg, 1.58 liters, 52.29%predicted respectively. Most common radiological finding was interlobular, interstitial septal thickening (79.8%). Commonest ILD was idiopathic pulmonary fibrosis (IPF). Gastroesophageal reflux disease was commonest comorbidity (76.42%). Follow-up of 67 patients was available. Therapy showed variable response as per the type of ILD. Nineteen deaths were recorded; 12 in IPF.

IPF was the commonest ILD with poorer prognosis and higher mortality compared to non-specific interstitial pneumonia despite optimal treatment while patients of connective tissue disease associated ILD, hypersensitivity pneumonitis and sarcoidosis show excellent response to therapy.

Bradley B, Branley HM, Egan JJ, et al. Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society. Thorax 2008; 63:v1–v58.
Travis WD, Costabel U, Hansell DM, et al. An official American Thoracic Society/European Respiratory Society statement: Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2013;188:733-48.
Kornum JB, Christensen S, Grijota M, et al. The incidence of interstitial lung disease 1995–2005: a Danish nationwide population-based study. BMC Pulm Med 2008;8:24.
Jindal SK, Malik SK, Deodhar SD, Sharma BK. Fibrosingalveolitis: a report of 61 cases seen over the past five years. Indian J Chest Dis Allied Sci 1979; 21:174–9.
Mahasur AA, Dave KM, Kinare SG, Kamat SR, Shetye VM, Kolhatkar VP. Diffuse fibrosing alveolitis - An Indian experience. Lung India 1983; 5:171–9.
Gagiya AK, Suthar HN, Bhagat GR. Clinical profile of interstitial lung diseases cases. National Journal of Medical Researc 2012; 2:2-4.
Venkata Ramana K. A Clinical and Radiological Profile of Interstitial Lung Diseases. IOSR-JDMS 2015;14:32-3.
Sharma SK, Pande JN, Guleria JS. Diffuse interstitial pulmonary fibrosis. Indian J Chest Dis Allied Sci 1984;26:214–9.
Kalra S, D'Souza G, Bhusnuramth B, Jindal SK. Transbronchial lung biopsy in diffuse lung disease. Indian J Chest Dis Allied Sci 1989;31:265–70.
Subhash HS, Ashwin I, Solomon SK, David T, Cherian AM, Thomas K. A comparative study on idiopathic pulmonary fibrosis and secondary diffuse parenchymal lung disease. Indian Journal of Medical Science 2004;58:185–90.
Sen T, Udwadia ZF. Retrospective Study of Interstitial Lung Disease in a Tertiary Care Centre in India. Indian J Chest Dis Allied Sci 2010;52:207–11.
American Thoracic Society, European Respiratory Society, World Association of Sarcoidosis and Other Granulomatous Disorders. Statement on sarcoidosis. Am J Respir Crit Care Med 1999;160:736-55.
Raghu G, Nyberg F, Morgan G. The epidemiology of interstitial lung disease and its association with lung cancer. Br J Cancer 2004; 91:S3–10.
Turner-Warwick M, Burrows B, Johnson A. Cryptogenic fibrosing alveolitis: clinical features and their influence on survival. Thorax 1980; 35:171–80.
Coultas DB, Zumwalt RE, Black WC, Sobonya RE. The epidemiology of interstitial lung diseases. Am J Respir Crit Care Med 1994;150:967–72.
Singh S, Collins BF, Sharma BB, et al. Interstitial lung disease (ILD) in India: results of a prospective registry. Am J Respir Crit Care Med 2016 DOI: http://dx.doi.org/10.1164/rccm... accessed on 5th January 2017.
Udwadia ZF, Sen T. Retrospective study of interstitial lung disease in a tertiary care centre in India. IJCDAS 2010;52:207- 11.
Johnston ID, Prescott BJ, Chalmers JC, Rudd RM. British Thoracic Society study of cryptogenic fibrosing alveolitis: current presentation and initial management. Thorax 1997; 52: 38-44.
Nagai S, Kitaichi M, Itoh H, Nishimura K, Izumi T, Colby TV. Idiopathic nonspecific interstitial pneumonia/fibrosis: comparison with idiopathic pulmonary fibrosis and BOOP. ERJ 1998;12:1010-9.
Cottin V, Nunes H, Brillet P, et al. Combined pulmonary fibrosis and emphysema: a distinct underrecognised entity. ERJ 2005; 26:586-93.
Raghu G, Freudenberger TS, Yang S, et al. High prevalence of abnormal acid gastro-oesophageal reflux in idiopathic pulmonary fibrosis. Eur Respir J 2006;27:136–42.
Tobin RW, Pope CE, Pellegrini CA, Emond MJ, Sillery J, Raghu G. Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998;158:1804–8.
Lancaster LH, Mason WR, Parnell JA, et al. Obstructive sleep apnea is common in idiopathic pulmonary fibrosis. Chest 2009; 136:772-8.
Vries JD, Kessels BLJ, Drent M. Quality of life of idiopathic pulmonary fibrosis patients. EurRespir J 2001; 17:954-61.
Patel NM, Lederer DJ, Borczuk AC, Kawut SM. Pulmonary hypertension in idiopathic pulmonary fibrosis. Chest 2007; 132:998-1006.