Interstitial Lung Disease Center
What are Interstitial Lung Diseases?
Interstitial lung diseases (ILD) are a diverse group of respiratory disorders that vary in severity and affect adults of all ages.The predominant symptoms of this class of diseases are cough and shortness of breath, symptoms that are similar to more common respiratory diseases such as asthma and COPD or emphysema. ILD can mimic recurrent pneumonia leading to a delay in diagnosis. Chest x-rays and CAT scans typically show abnormalities that involve more than one region of the lungs. Lung function testing, while normal in mild cases, may show reduced lung volumes and low oxygen levels. Because interstitial lung diseases vary with respect to the severity of symptoms and prognosis, being diagnosed with an ILD can be confusing and frightening to patients.
Team Approach to Care at BIDMC
Physicians who do not care regularly for patients with interstitial lung disease can find the management of these diseases challenging. Recent clinical guidelines doubt the efficacy of conventional therapies for some ILD's because of negative results of several large clinical trials in this area. Standard anti-inflammatory therapy, the historical approach to treatment, has therefore become controversial. More so than other groups of lung diseases, treatment decisions are often influenced by local practice patterns and might not reflect the most current developments.
Because patients with this group of diseases are not seen with great frequency by community practitioners, access to experts who routinely see patients with ILD is beneficial. The physicians seeing patients in the interstitial lung disease clinic have years of both clinical and research experience. We place a tremendous emphasis upon availability to our patients and communication with referring or co-managing physicians. We believe that a team of experienced practitioners, including pulmonologists, pathologists, radiologists, thoracic surgeons and physical therapists expert in pulmonary rehabilitation, allows us to optimize care for individuals with ILD.
Getting Treatment at BIDMC
Depending upon the acuity of the referral, we can see an initial consultation promptly, within days if necessary. Initial visits involve lung function testing and an hour long appointment with a physician. The evaluation continues at relevant conferences where challenging cases are reviewed and discussed in a group setting. In addition, we hold a bi-weekly meeting which brings together chest radiologists and pulmonary colleagues to discuss and debate questions of diagnosis and treatment on a case by case basis. Other members of the ILD Center provide input when appropriate, including rheumatology and thoracic surgery. All consultations are enhanced by this collaborative effort of dedicated health care providers with varied expertise.
Investigative Site for Major Drug Trials
The Beth Israel Deaconess pulmonary division participates extensively in clinical trials pertaining to interstitial lung diseases. For idiopathic pulmonary fibrosis, we have been an investigative site for major recent drug trials including such experimental therapies as interferon-gamma, pirfenidone and bosentan.
We are readily available to discuss with both physicians and patients which trials are open currently and which trials we anticipate opening in the future. We will also be launching independent research efforts focused upon gaining a better understanding of the cause of this class of diseases and identifying relevance therapeutic targets for future therapies.
Interstitial Lung Diseases
- Idiopathic pulmonary fibrosis
- Lung fibrosis or inflammation related to rheumatological disease (rheumatoid arthritis, scleroderma, sjogren's syndrome, among others)
- Lung fibrosis or inflammation caused by medications, chemotherapy or radiation
- Bronchiolitis obliterans organizing pneumonia (BOOP)
- Nonspecific interstitial pneumonitis
- Hypersensitivity pneumonitis
- Eosinophilic pneumonia
- And others
- Dr. Joseph Zibrak - pulmonary
- Dr. Sidhu Gangadharan - thoracic surgery
- Dr. Philip Boiselle - chest radiology
- Dr. Paul Spirn - chest radiology
- Dr. Alex Bankier - chest radiology
- Dr. Diana Litmanovich - chest radiology
- Dr. Olivier Kocher - pathology