“en”:”My name’s Dr. Jim Allen. I’m a pulmonary and critical care physician at the Wexner Medical Center at The Ohio State University. I’m also a professor of internal medicine at Ohio State. The focus of my outpatient practice is in interstitial lung disease. And interstitial lung diseases are a large group of about a hundred and fifty different diseases that are all brought together by having inflammation, or scarring or both in the lungs. And these are a rare group of diseases that can be very similar appearing to each other and so it really requires a very careful and multidisciplinary evaluation of these patients.
My own general approach to patients with interstitial lung disease is to start off with a careful history and physical examination and then do additional laboratory testing, pulmonary function testing and high resolution CAT scanning. When we talk about the inflammation and scarring in the lung in interstitial lung disease, the best way to see that early on is really with imaging like a chest x-ray or a CAT scan. And in that situation you can actually see the inflammation and the scarring within the lung tissues themselves. Now sometimes you can’t tell how much is scar and how much is inflammation just on the CAT scan and that’s why a surgical lung biopsy is sometimes necessary. With interstitial lung disease it’s really important to establish a confident diagnosis. Now sometimes we can do that just with the outpatient testing, but in other patients we have to do a surgical lung biopsy, which requires admission to the hospital.
After the biopsy we’ll present our patients at our multidisciplinary interstitial lung disease conference where we get the lung specialists, the pathologists and the radiologists all in one room so that we can talk amongst each other and really come up with a confident consensus diagnosis of what the patient actually has. After that we then see the patients back in the office and can work out a treatment plan that’s unique and specific to that person’s diseases. And since there’s about a hundred and fifty interstitial lung diseases that can involve a lot of very different treatment plans.
Some of the interstitial lung diseases are more severe and they can even be fatal. But we do have medications that can slow them down and improve the quality of life and often improve the duration of life. For many patients with interstitial lung disease we can offer them lung transplantation if they otherwise meet the criteria for transplant. One of the exciting things about caring for patients with interstitial lung disease at Ohio State is that we also have access to a lot of clinical trials.
And these are experimental medications that wouldn’t necessarily be available through your regular pharmacy but offer a lot of hope for treatment for the patients who come down with interstitial lung disease in the future. So we really have a fairly comprehensive program for interstitial lung diseases here at Ohio State and we really think that having the research component of it gives our patients the best chance for not only standard treatment, but also for the cutting edge, new, possible treatments that are in the future. Interstitial lung diseases can present with really very nonspecific symptoms. So cough and shortness of breath are often the main symptoms and patients can have those same symptoms with many forms of of lung disease.
Some of these diseases can be inherited, some of them are acquired, some of them can be occupationally related like asbestosis or silicosis. So it’s really important to take a careful history that is going to include the family history, the occupational history, any recreational exposures, pets, travel history, medications, all of those can sometimes be related to the ultimate diagnosis. In being an interstitial lung disease doctor is often a lot like being a detective and you have to take all the clues and put them together.
And it often takes several detectives in one room to really come up with a confident diagnosis and that’s why the pathologist and the radiologist can be just as important as the pulmonologist.. “
As found on Youtube
Interstitial Lung Disease: Diagnosis and Treatment
No comments:
Post a Comment