Early recognition in the primary care setting is a high priority1

Presenting ILD symptoms can be nonspecific, including1:

  • Cough1

─ Ask patients about frequency, duration, timing, and productivity of cough2

  • Dyspnea1,3

─ Ask patients about timing, severity, and cause of dyspnea1

  • Fatigue1

─ Ask patients with fatigue about duration of fatigue, sleep quality, mood, and medications4

ILD is often mistaken for more common diseases, such as1:

  • COPD
  • Bronchitis
  • Emphysema
  • Asthma
  • CHF

ILD diagnosis can be delayed5:

  • On average, there is a delay of 2.7 years from initial respiratory diagnosis to a diagnosis of IPF5 Based on a retrospective cohort analysis of 44,891 adults ≥50 years of age with their first coded clinical diagnosis of IPF in the Center for Medicare Services Fee for Service database between 2014 and 2019.
  • Diagnosis sometimes requires 3 or more different doctors6

A multidisciplinary team approach is regarded as the standard for diagnosing ILD7

5 person multidisciplinary team graphic5 person multidisciplinary team graphic

Your vigilance can make a difference in the diagnosis of ILD1

Patients share their experiences during the diagnostic process

ILD patient 4

It took years to get to the bottom of my symptoms. I met with a pulmonologist, who performed numerous tests. He made sure to account for everything he could—he factored in my PFT results and HRCTs, which showed honeycomb scarring of my lungs...he was relentless, and that's exactly the kind of care I needed.
-Charles, living with SSc-ILD

ILD patient 5

One day I walked into his office, he asked, "How long have you been short of breath?" I hadn't even noticed it—but I did notice that he looked frightened when he asked me. He told me the shortness of breath meant I was compensating for something and sent me for a pulmonary function test and some CT scans. The results were shocking: I'd lost 52% of my lung function.
-Dale, living with myositis-related ILD

ILD patient 6

I was treated with over-the-counter meds for a cough and sent on my way. Months passed. Actually, I'd gotten used to the coughing. It was the type of cough that would grab me by the throat and squeeze until I couldn't get the air in or the words out. My pulmonologist ordered a high-resolution CT scan...it would be the CT scan that would offer a diagnosis.
-Kay, living with IPF

Presenting symptoms of ILD are nonspecific graphic Recognize signs of ILD 
Testing for ILDs graphic Learn about reviewing tests and scans 
Document graphic with message about resources for you and your patients View resources 
Magnifying glass graphic with message to discover more about ILD Visit the site 

CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CT, computed tomography; HRCT, high-resolution computed tomography; ILD, interstitial lung disease; IPF, idiopathic pulmonary fibrosis; PFT, pulmonary function test; SSc-ILD, systemic sclerosis-associated interstitial lung disease.

References

  1. Zibrak JD, Price D. NPJ Prim Care Respir Med. 2014;24:14054.
  2. Michaudet C, Malaty J. Am Fam Physician. 2017;96(9):575-580.
  3. Ryu JH et al. Mayo Clin Proc. 2007;82(8):976-986.
  4. Rosenthal TC et al. Am Fam Physician. 2008; 78(10):1173-1179.
  5. Herberts MB et al. BMC Pulm Med. 2023;23(1):281.
  6. Althobiani MA et al. Front Med (Lausanne). 2024;11:1296890.
  7. Walsh SLF et al. Lancet Respir Med. 2016;4(7):557-565.