Q: I want to know about ILD (Interstitial Lung Disease) whether the prednisolone 0.125 mg/kg can be taken indefinitely by the ILD patient. What is the life expectancy of a patient of ILD?

A:Interstitial lung disease is a complex category of lung pathology characterized by an inflammatory reaction that progresses at variable rates to cause architectural damage and stiffening of the lung from fibrous scarring. The disease advances at different rates, so that some patients are only mildly symptomatic and may stabilize or improve, whereas others have a rapid decline with advancing respiratory failure. No clear cause exists in many cases; others seem to be due to viral infection, toxin exposure or a reaction to an environmental irritant. The individual response to any of these causes is not explained, and likewise no specific cure works for every patient. Steroids may help, and several weeks of a high dose is often given by experts, with the inevitable complication of steroid side effects. A specialist physician must judge whether the balance of responses favours continuing therapy at a high dosage level, or whether a reduced dosage schedule would be appropriate. Other drugs such as immunosuppressives may be tried, but the response is often poor. There are experimental drugs, but none are of clear value at this time. Oxygen is often required in advanced disease, and ventilator support may eventually be required. Finally, lung transplantation may be an option in crippling disease.