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Rady Children's Specialists

Diffuse Lung Disease (DLD) Program

We understand how stressful it is when your child has a breathing problem, especially one that is difficult to diagnose. Here at Rady Children’s Hospital-San Diego, we have one of a handful of specialized programs nationwide that diagnoses and treats diffuse lung disease (DLD) and childhood interstitial lung disease. These are broad terms for a group of rare lung diseases that can affect babies, children and adolescents.

  • Diffuse literally means “all over,” as opposed to in just one spot (like pneumonia) or in just the airways (like asthma). This kind of lung disease is unusual, which is why you have been referred to a specialist.
  • Interstitial means “in between.” The lung is made up of airways (tubes that take the air down into the lungs), blood vessels (arteries and veins) and millions of tiny air sacs (alveoli). The interstitial space is everything in between these air sacs, like the space between the walls of your house where the wires and insulation are located.

Common symptoms of DLD include:

  • Fast breathing
  • Retractions (use of rib or neck muscles to breathe)
  • Shortness of breath
  • Abnormal lung sounds
  • Low oxygen levels
  • Chronic cough
  • Frequent respiratory infections
  • Poor weight gain
  • “Clubbing” of the fingers and toes

Children with DLD often have an abnormal chest X-ray or CT scan.

Our Team and Expertise

The DLD Program is a Children’s Interstitial and Diffuse Lung Disease Center of Excellence.

James Hagood, M.D., is the center’s director and chief of the Division of Respiratory Medicine. He has helped the American Thoracic Society develop guidelines for the diagnosis and management of childhood interstitial lung disease, is an advisor to the Children’s Interstitial Lung Disease Foundation and conducts research on lung fibrosis (scarring).

Dr. Hagood leads a multidisciplinary team that includes board-certified pediatric pulmonologists, dietitians, social workers, pediatric nurse practitioners and respiratory therapists. We also have expert radiologists and pathologists who understand the rare diseases that make up DLD.


Often, when a doctor suspects diffuse lung disease, it turns out to be something else. At your child’s first appointment, we will review your child’s records to be sure we are not dealing with a more common problem.

If diffuse lung disease is still suspected, special tests may be ordered. Getting a correct diagnosis is vital for understanding and treating your child’s condition.

To make an appointment to have your child evaluated, please call 858-966-5999.