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Interstitial lung disease refers to a group of
lung diseases characterized by scarring (fibrosis) and/or inflammation of
the lungs that gradually interfere with a person's ability to breathe. While
there are many known causes of interstitial lung disease, the cause in many
cases remains unknown. The following is a partial list of diseases we treat:
- Idiopathic Pulmonary Fibrosis (IPF)
- Non-Specific Interstitial Pneumonia (NSIP)
- Cryptogenic Organizing Pneumonia (COP or BOOP)
- Desquamative Interstitial Pneumonia (DIP)
- Respiratory Bronchiolitis-Related Interstitial
Lung disease (RB-ILD)
- Acute Interstitial Pneumonia (AIP or Hamman-Rich)
- Autoimmune (Collagen-Vascular)-Related Interstitial
Lung Disease
- Hypersensitivity Pneumonitis
- Drug-Related Interstitial Lung Disease
- Exposure-Related Interstitial Lung Disease
(occupational and environmental exposures)
- Langerhan's Cell Histiocytosis (Eosinophilic
Granuloma, Histocytosis X)
- Lymphangioleiomyomatosis (LAM)
- Bronchiolitis
- Sarcoidosis
- Vasculitis-Related Interstitial Lung Disease
- Diffuse Alveolar Hemorrhage
- Eosinophilic Pneumonias
- Pulmonary Alveolar Proteinosis
- Lymphoplasmacytic Interstitial Lung Diseases (LIP)
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UCSF Interstitial Lung Disease Center of Excellence
is a full-service consultative practice specializing in the care of people with
Interstitial Lung Disease. Our mission is the following:
- To provide comprehensive, state of the art diagnosis
and care for patients with interstitial lung disease in a consultative practice
setting
- To provide guidance to patients and to providers
regarding the management of interstitial lung disease
- To investigate the causes of, and to improve treatments
for, interstitial lung diseases through research and clinical trials
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At the UCSF ILD Center of Excellence, we work as a
team of lung specialists, chest radiologists, and pathologists (doctors who examine
lung tissue from biopsies) to diagnose interstitial lung disease and to develop an
individualized plan of treatment through:
- A comprehensive review of your history
- A thorough analysis of your diagnostic studies
- Facilitating further work-up if necessary
We keep you and your referring doctor informed of our
findings and treatment plan.
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Pulmonology:
Harold A. Chapman, MD
Harold R. Collard, MD
Kenneth C. Fang, MD
Michelle Freemer, MD
Jeffrey A. Golden, MD
Talmadge E. King, Jr. MD
Laura Koth, MD
Nadia Tchao, MD
Paul J. Wolters, MD
Radiology:
Rick Webb, MD
Brett Elicker, MD
Pathology:
Kirk Jones, MD
Stephen Nishimura, MD
Research Associates:
Michele R. DesMarais, MS
Renee Jeffrey, BA
Debbie Koehler, BS
Advanced Lung Disease Nurse:
Sally McLaughlin, RN, MSN
Clinic Coordinator:
Connie Barbante
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The initial consultation process at the UCSF
ILD Clinic typically is as follows:
- Arrive at the clinic at your scheduled
appointment time
- Meet with the chest clinic nurse for weight
and vital signs
- Meet briefly with our clinical coordinator
to discuss your optional participation in the ILD clinical research
database (please see the section on "Research Activities" below)
- Consult with your ILD doctor (typically 60
to 90 minutes in length)
- Meet with our Advanced Lung Disease Nurse
or ILD Clinical Coordinator to review recommendations, arrange any
further testing ordered, and answer additional questions
After you leave the clinic, the following
events will occur:
- The ILD doctors will meet as a group to
discuss your case, review your radiology and pathology materials, and
finalize impressions and recommendations.
- A comprehensive letter describing your
doctor's findings as well as the most appropriate treatment approach
for your particular situation will be mailed to both you and to your
referring physician.
Please realize that interstitial lung diseases
can require significant time and testing to accurately diagnose. You
may need to have several meetings with your doctor to finalize a
diagnosis and treatment approach.
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The following tests are often used to diagnose
and manage interstitial lung disease. You may be asked to have some or
all of these tests performed during your visit to UCSF.
- Pulmonary function testing: Pulmonary
function testing involves a series of breathing maneuvers that allow
for the measurement of airflow and volume of air in your lungs. This
allows your ILD doctor to objectively assess the function of your
lungs. We recommend all ILD patients have PFT testing performed.
Adult Pulmonary Function Laboratory Home Page
Pulmonary Function Testing Information
Lung Disease Testing Information
- High resolution computed tomography
(HRCT): This is a special type of CT scan that gives your ILD doctor
high-resolution images of your lungs. These images are extremely
valuable in determining what type of ILD you have. We recommend all
ILD patients have a HRCT performed. From a patient perspective, the
experience of HRCT is no different that a regular CT scan. They are
performed on an open-air table and take only a few minutes to perform.
Radiology Home Page
- 6 minute walk testing: 6 minute walk testing
is a formal evaluation of the distance you can walk and the oxygen
saturations (measured by finger or ear probe) you achieve while
walking. This is an important marker of functional status used by your
ILD doctor in managing your ILD. We recommend all ILD patients have a
6 minute walk test performed.
Six-Minute Walk Test Information
- Bronchoscopy: Bronchoscopy involves the
passage of a flexible fiberoptic scope about the diameter of a pencil
into the lungs to obtain fluid and sometimes tissue samples to aid in
diagnosis. Some patients with ILD may benefit from a diagnostic
bronchoscopy. This procedure is done by your ILD doctor as an
outpatient procedure (in other words, you do not need to stay
overnight in the hospital). If recommended, it will require a separate
appointment.
Bronchoscopy Information
- Surgical lung biopsy: In some patients with
ILD, a surgical lung biopsy is required to definitively diagnose the
cause of their lung disease. Surgical lung biopsy is generally done
with the use of small tools and cameras through 3-4 incisions each
only an inch or so long (this procedure is called video-assisted
thoracoscopic surgery). A surgical lung biopsy is performed by a
cardiothoracic surgeon and requires a few day stay in the hospital.
Open Lung Biopsy Information
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Depending upon the type and course of your lung disease,
lung transplantation may be an appropriate and important part of your management.
When you visit with your ILD doctor, you can discuss this. The UCSF Interstitial
Lung Disease Center of Excellence works closely with the UCSF Lung Transplant Team to
coordinate referral for appropriate patients.
UCSF Lung Transplant Site
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For some interstitial lung disease, there is no known
effective therapy. Therefore, research into the causes and best management of this
disease is extremely important.
The UCSF ILD Center of Excellence is not only a clinic for patient care, but also
an active research center. Our research is a collaborative effort among patients,
providers, and scientists. We carry out two types of interstitial lung disease
research programs:
- Basic research - this is experimental work, carried out
in a laboratory, which helps us to better understand the fundamental, cellular
mechanisms of interstitial lung disease
- Clinical trials - these programs use the knowledge gained
in basic research to study the benefits of new treatments in patients
During your visit you may be asked if you are interested
in participating in research. It is completely voluntary and the decision whether or
not to participate will not impact your care in any way.
Funding for our research comes from a variety of public and private sources. Below are
more details on ongoing research studies at UCSF:
- IPFnet research studies: We are a member of the National
Institutes of Health sponsored Idiopathic Pulmonary Fibrosis Clinical Research
Network (IPFnet). The IPFnet includes 11 centers across the United States and was
formed to conduct research to improve treatments for IPF, a form of ILD.
The IPFnet
is currently enrolling participants! For additional information on the
IPFnet, please visit the IPFnet website at www.ClinicalTrials.gov
- Industry-sponsored research studies: Industry-sponsored
studies have contributed greatly to our understanding of ILD. We commonly have
several ongoing industry-sponsored trials for patients with specific forms of ILD.
Your ILD physician may mention these to you if you appear to meet the criteria for
involvement. Please feel free to ask about these trials when you meet with your ILD
doctor.
- Investigator-initiated research studies: In addition to
the IPF-net and industry-sponsored research trials, UCSF has a number of ILD
physician and researcher initiated research studies that you may be eligible to
participate in. All ILD patients are asked if they will allow basic clinical
information about them and their disease (for example, your age, gender, diagnosis,
lung function testing results) to be stored in the UCSF ILD clinical database and if
they are willing to allow blood or other tissue that is unused for diagnostic
purposes to be stored in the UCSF ILD tissue bank. Both of these research projects
are highly secured and no potentially identifying information (for example your name,
birthdate, address) is ever released. Participation in these, and other ongoing UCSF
investigator initiated-research projects is completely voluntary and your decision as
to whether or not to participate in no way affects your clinical care. Please feel
free to ask your ILD doctor for more information about these research studies.
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There are several ways to contact us to arrange an
appointment in the UCSF Interstitial Lung Disease clinic:
- You can request a referral from your doctor (general
pulmonologist or primary care provider) and fax it to us at (415) 353-2568.
This referral request should briefly describe your medical problem, especially
information about your interstitial lung disease. Please also include your contact
information (name, home address, telephone number) as well as your doctor's contact
information.
We will then call you and arrange an appointment.
- You may also call the clinic appointment desk at (415)
353-2961 or contact the clinic nurse at (415) 353-2577. We will ask you to fax or
mail us a referral (see above), as well go over the materials needed at your first
appointment.
- Our mailing address is:
UCSF Interstitial Lung Disease Center of Excellence
400 Parnassus Avenue
5th Floor Chest Clinic
Box 0359
San Francisco, CA 94143
The USCF ILD doctors see patients during clinic on
Fridays, from 8 am to 12 pm only.
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Once an appointment has been scheduled, an information
packet will be mailed to you. This packet includes a health questionnaire as well as
requests for certain important materials and tests. The questionnaire should be
completed prior to the first visit. Your referring physician's office can help you
gather the requested materials. These materials are extremely important for the proper
diagnosis of the interstitial lung diseases, and make for a productive first visit:
- Insurance authorization for the visit -
if required by your insurance
- Completed health questionnaire -
we will mail this to you
- Referring physician information -
so that we may communicate our findings and recommendations
to your referring physician
- Clinical records -
including a history and physical from your referring
physician, showing the diagnosis of interstitial lung disease, and any
hospitalizations
- Chest x-rays -
the actual electronic or printed copies of the images are
requested for the doctor to review, in addition to the written report
- High resolution chest CT scans -
the actual electronic or printed copies of the CT images
are requested for the doctor to review, in addition to the written report
- Laboratory studies -
blood tests as well as any sputum cultures performed
- Pulmonary function tests -
both current and past PFTs and spirometry
- Bronchoscopy report
- Lung biopsy slides and report -
the actual slides and tissue block in addition to the
written report
- Echocardiogram report
Printed materials can be faxed to the clinic at
(415) 353-2568. Copies of all reports and x-ray/high resolution CT films
(of CD) should be hand-carried to the first appointment. If this is not possible,
these items may be mailed to the following address:
UCSF ILD Center of Excellence
ATTN: Connie Barbante
Chest Clinic, 5th Floor Ambulatory Care Center
Box 0359
400 Parnassus Ave
San Francisco, CA 94143
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The UCSF Interstitial Lung Disease Center of
Excellence is located in the Chest Clinic, 5th Floor of the Ambulatory Care
Clinic Building at 400 Parnassus Avenue, San Francisco, California.
Driving Directions | Map
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