Cough and difficulty breathing, beware of pulmonary fibrosis! If you have this kind of "autoimmune disease", you need to check it out early
Not just the sequelae of COVID-19! Autoimmune diseases can also cause pulmonary fibrosis
Since the COVID-19 epidemic caused a global pandemic, people have gradually become aware of the dangers of “pulmonary fibrosis”. In fact, not only the sequelae of pneumonia caused by the COVID-19 virus, but also the idiopathic pulmonary fibrosis (Caiguabu lung) that is often heard by the public, has been Immune diseases such as scleroderma are also likely to cause pulmonary fibrosis. Research shows that 75% of scleroderma patients will be complicated by pulmonary fibrosis (SSc-ILD), and the mortality rate will increase three times.
Dr. Cai Yingming, Department of Thoracic Medicine, Chung Ho Hospital, Kaohsiung Medical University, pointed out that it is difficult for normal people to imagine the seriousness of pulmonary fibrosis. During the process of continuous fibrosis, the lungs lose their normal function of gas exchange, and symptoms of cough and dyspnea continue to worsen. , the patient is like drowning, suffering an unbearable sense of suffocation every minute.
Pulmonary fibrosis can be fatal! If you have cough or difficulty breathing, check your lung function as soon as possible
Dr. Cai Yingming once treated a 70-year-old female scleroderma patient. Three years ago, she began to cough and have difficulty breathing. After examination, it was found that 15% of the lungs had fibrosis. She started to wheeze severely after walking a few steps. , not only the scope of living can only be limited to home, but also rely on family members for help in daily life. It was not until he received anti-pulmonary fibrosis drug treatment that his symptoms improved and he no longer suffered from shortness of breath all day long.
Dr. Cai Yingming said that the treatment of autoimmune diseases is mainly in the rheumatism, allergy and immunology department, but patients should have the concept of routinely checking lung function and chest computed tomography. Once cough, dyspnea and other symptoms suspected of pulmonary fibrosis occur, it is recommended to go to the chest as soon as possible. Arrangement of examinations by the internal medicine department is helpful for early detection of lung changes and timely rescue of lung function.
About 20-30% of autoimmune diseases fail to diagnose pulmonary fibrosis in time, which shows that most patients only pay attention to visible signs such as skin and joints during treatment, and ignore potentially fatal comorbidities. Dr. Cai Yingming pointed out that there are no symptoms in the early stages of pulmonary fibrosis, and patients have insufficient awareness of pulmonary fibrosis. Even if they gradually develop symptoms such as cough and dyspnea, they will not report it to the attending physician. When the symptoms become serious, examinations will be arranged. Most of the lung function has been severely damaged.
Lung damage is irreversible! Early treatment reduces acute exacerbations
The scary thing about pulmonary fibrosis is that the damage to the lungs is irreversible, and continuous inflammation and fibrosis are like a vicious cycle of repeated scarring of wounds. In particular, nearly 30% of pulmonary fibrosis caused by autoimmune diseases will develop into progressive fibrosing interstitial lung disease (PF-ILD). The lungs are in an extremely fragile state and are easily stimulated by external factors to induce acute deterioration, leading to lung disease. Function declines very quickly, often requiring intubation.
Dr. Cai Yingming reminded that early detection and active treatment before the lung function loses its normal function is the key to improving the prognosis. He called on patients to conduct routine pulmonary function tests so that changes in lung function can be monitored and necessary treatment can be given in a timely manner. The emergence of anti-pulmonary fibrosis drugs has changed the past dilemma of patients with scleroderma combined with pulmonary fibrosis who had no cure.
Currently, anti-pulmonary fibrosis drugs used to treat progressive fibrotic interstitial lung disease have been shown in clinical trials to reduce the decline in lung function by 57%. In addition, analysis results for Asian groups also show that it can reduce the risk of acute exacerbation and death by 74%. In June last year, patients with scleroderma complicated by pulmonary fibrosis were allowed to apply for health insurance benefits for anti-pulmonary fibrosis drugs. The medical community hopes that other policies will be opened in the future. Indications for use in autoimmune diseases combined with pulmonary fibrosis.
People with autoimmune diseases schedule pulmonary function tests every 3 to 6 months
Dr. Cai Yingming reminded that pulmonary fibrosis mostly starts from the lower lung lobes, and continuous crackles can be heard in the lower lung lobes on the back after auscultation. It is recommended that patients with autoimmune diseases should take pulmonary function tests as a routine item and arrange a pulmonary function test every 3 to 6 months. When abnormal crackles are found through auscultation, a high-resolution computed tomography (HRCT) scan should be performed for further update. Detailed differential diagnosis.
Dr. Cai Yingming called on patients with scleroderma to pay more attention to pulmonary complications and report suspected pulmonary fibrosis symptoms to the attending physician as soon as possible. Now major medical centers are implementing a multi-specialty care model that combines rheumatology and immunology and thoracic medicine. and other interdisciplinary professional medical teams to provide patients with comprehensive pulmonary fibrosis treatment care.
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