Clinical and radiological spectrum of interstitial lung disease in a north Indian state: A single centre study

Abstract

Background: The present study was carried out with an aim of understanding the types of Interstitial lung disease (ILD) and their radiological patterns in the north Indian state of Jammu and Kashmir. Methods: The present study was a prospective observational study conducted over a period of 2 years in Sher-i-Kashmir Institute of Medical Sciences- Medical College, Bemina, Srinagar. All consecutive patients referred to the department for High Resolution CT scan (HRCT) of the chest with suspected diagnosis of ILD based on clinical features, spirometry and chest X-ray findings, who gave consent for the study were included. Clinical, biochemical, serological and radiological parameters were assessed and the diagnosis of various ILDs was made based on standard international criteria. Results: A total 122 patients of ILD were enrolled over a period of 2 years in the present study. Mean age of the patients was 63.4 ± 19.7 years and majority (59.8%) were males. 41.8% patients were current or previous smokers. Mean symptom duration before diagnosis was 3.1 ± 1.7 years. Exertional breathlessness (98.4%) and cough (94.3%) were the most common symptoms. Hypertension (70.5%) and gastroesophageal reflux disease (62.3%) were the most frequent comorbidities. On HRCT thorax ground glass opacities (52.5%) were the most common finding, followed by interlobular (39.3%) and intralobular (34.4%) septal thickening. Diffuse pattern of lung involvement was seen in 41.8% and predominant upper/middle lobe involvement in 33.6%. Idiopathic pulmonary fibrosis (29.5%) was the most common form of ILD, followed by Nonspecific interstitial pneumonia (23.8%) and hypersensitivity pneumonitis (15.6%). Gujjar lung, a unique form of ILD in Kashmir, was diagnosed in 2.5% patients. Conclusion: The present study is the first from the state of Jammu and Kashmir assessing the radiological spectrum and types of ILD in this part of country. It provides a useful insight into the clinical and radiological patterns of ILD in our population and highlights the need for larger prospective multicentre registries to assess the true incidence and prevalence of ILD in the country.