1. Identifying and determining the cause of interstitial lung disease can be challenging &Treatment has limitations

2. Certain bloodwork can detect proteins, antibodies and other markers of autoimmune diseases or inflammatory responses to environmental exposures, such as those caused by molds or bird protein.

3. Computerized tomography (CT) scan imaging test is key to, and sometimes the first step in, the diagnosis of interstitial lung disease.

4. Echocardiogram must for right heart evaluation.

5. Spirometry and diffusion capacity are must for detalied

6. Oximetry is a simple test for monitoring and follow up

7. FVC monitoring tells the progress of disease

8. The lung scarring cannot be reversed but disease can be stabilized in selected patients.

9. Oral steroids are drug of choice,

10. Judicious use of oral steroids are must.

11. Long term steroids cause myopathy and Addison’s disease.

12. Check morning and evening Serum Cortisol for evaluating steroid suppression.

13. ACTH injections in low cortisol stage are advised

14. Pirfenidone and nintedanib may slow the progress of disease

15. Gastroesophageal reflux disease (GERD) affects the majority of people with pulmonary fibrosis and is associated with worsening lung damage.

16. Structured Pulmonary rehabilitation is advised from early stage of disease