Disease that claimed Tiger is a grey area in research


Interstitial lung disease, which late cricket legend Mansoor Ali Khan Pataudi was suffering from, is still largely a "mystery disease" according to pulmonary experts, who call it a grey area in research. No large-scale, population-based study has ever been done, say doctors, while acknowledging an anecdotal rise in incidence in the last decade.

ILD causes a rapid, progressive infection in the interstitium, the space between the outer wall of alveoli and the capillaries, and through which exchange of gases takes place. The primary symptom is breathlessness, the breathing rate trebling from a normal 12-15 breaths per minute to about 40-50.

"There is a broad spectrum of interstitial lung diseases," said Dr Neeraj Jain, chief of the pulmonology department at Sir Ganga Ram Hospital, where he led the team treating Pataudi. "Pataudi was diagnosed with the most extreme form, idiopathic pulmonary fibrosis. Here, the thin membrane becomes swollen, there is scarring in the lungs. As a result the lungs cannot hold oxygen, despite external support."

In milder forms, there is some swelling in the interstitial membrane but no scarring. "Though the cause of the swelling is not established, if it is mild it becomes manageable with steroids... the body adapts to a mild loss in the oxygen capacity of the lungs," Dr Jain said.

There are hypotheses on what leads to ILD, though the precise cause is not clear. One theory involves reactions to toxic factors in the environment. Another is about auto-immune disorders multiple sclerosis, scleroderma, Lyme disease where the immune system reacts against the body. Reaction to certain drugs for cancer and cardiac problems, too, is believed to be a possible cause.

What leads to the fibrosis is again unclear. Dr S K Jindal, head of the country's oldest pulmonary medicine department at PGI Chandigarh said, "The term idiopathoic is only used when the cause of the fibrosis of the interstitial membrane is unknown. We know that for some reason, there is a deposition of a fibrous substance called collagen that causes thickening of the membrane. But we do not know what causes this deposition."

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