January 2018 pulmonary case of the month

Abstract

No abstract available. Article truncated after 150 words. History of Present Illness: A 67-year-old man from Idaho was seen in November 2017 for a second opinion. He has a history of slowly progressive dyspnea on exertion for 7 to 8 years. He has a significant smoking history of 50 pack-years, but is still smoking “a few cigarettes”. He saw an outside pulmonologist in September 2017 and was noted to have abnormal pulmonary function testing with the primary abnormality being a low DLco. A thoracic CT Scan was reported to be abnormal with evidence of interstitial lung disease. He underwent video-assisted thorascopic surgery and the biopsies were reported to show usual interstitial pneumonitis (UIP). His pulmonologist questioned whether this was interstitial pulmonary fibrosis or UIP associated with rheumatoid arthritis. PMH, SH and FH: He has a history of rheumatoid arthritis and had been treated with methotrexate for approximately 8 years. His methotrexate had been discontinued in September with no …

Keywords

• desquamative interstitial pneumonitis
• DIP
• desquamative interstitial pneumonia
• smoker's macrophages
• smoking
• treatment
• smoking cessation
• corticosteroids
• prognosis
• CT scan