Interstitial lung disease (ILD)

The Royal Free London is a specialist centre for the diagnosis and management of interstitial lung diseases (ILD). We manage the care of over 1,200 patients with a large spectrum of ILDs.

ILDs include a large number of conditions which affect the lungs. Some are acute (severe and sudden) illnesses but most are chronic (long-developing) conditions that may result in lung scarring causing progressive shortness of breath. It is important to get an accurate diagnosis.

Our service has weekly multidisciplinary meetings which include respiratory and rheumatology physicians, and specialist chest radiologists to discuss the diagnosis and treatment plan for individual patients. In most cases we provide an extensive assessment of causes including a questionnaire, autoimmune testing and specialist bronchoalveolar sampling.

Many ILDs occur because of an underlying autoimmune disease such as rheumatoid arthritis or lupus; we can provide immunosuppressive treatments for connective tissue disease ILDs such as these. As a specialist centre and with strong academic links to UCLH and the Royal Brompton Hospital we are also able to offer:

  • diagnostic tests using a multidisciplinary approach, including minimally invasive lung biopsy and novel imaging to ensure accurate diagnosis and management
  • referral to UCLH for NICE approved specialist treatments including pirfenidone and nintedanib for idiopathic pulmonary fibrosis
  • bronchoscopy with EBUS and bronchoalveolar lavage to aid diagnosis and treatment of patients with ILD
  • open lung biopsy, if required
  • early review for lung transplantation and referral if appropriate
  • assessment for oxygen (at night or ambulatory)
  • shared care of patients with underlying collagen vascular diseases (with rheumatology colleagues)
  • the opportunity to participate in national and international research studies
  • specialist respiratory nurse involvement and support.

We are in the process of applying for inclusion on the national idiopathic pulmonary fibrosis registry.