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  • #303934
    casey
    Participant

    Hi All,

    Can a pulmonary function test alone  tell if one has pulmonary  fibrosis?

    Thanx,

    Casey

    #345338
    Maz
    Keymaster

    [user=9]casey[/user] wrote:

    Can a pulmonary function test alone  tell if one has pulmonary  fibrosis?

    Hi Casey,

    Just did a little research on this and googled, “Diagnostic Criteria for Pulmonary Fibrosis.” Lots of sites came up you can check thru.

    Wiki had a nice little summary:

    http://en.wikipedia.org/wiki/Pulmonary_fibrosis#Symptoms_and_diagnosis

    “Symptoms and diagnosis

    Symptoms of pulmonary fibrosis are mainly:

    • Shortness of breath, particularly with exertion[1][/suP][/*:653m02uq]
    • Chronic dry, hacking coughing[1][/suP][/*:653m02uq]
    • Fatigue and weakness[1][/suP][/*:653m02uq]
    • Chest discomfort[1][/suP][/*:653m02uq]
    • Loss of appetite and rapid weight loss[1][/suP]

    [/*]
    Pulmonary fibrosis is suggested by a history of progressive shortness of breath (dyspnea) with exertion.[5][/suP] Sometimes crackles can be heard in the chest with stetoscope.[5][/suP] A chest x-ray may or may not be abnormal, but high Resolution CT will frequently demonstrate abnormalities. [5][/suP]

    The diagnosis can be confirmed by lung biopsy.[5][/suP] An open surgical biopsy, meaning that the chest wall is surgically opened under general anesthesia to remove a portion of lung tissue, may be necessary to obtain enough tissue to make an accurate diagnosis.[5][/suP] The removed tissue is examined histopathologically by microscopy to confirm the presence of fibrosis. [5][/suP]

    Misdiagnosis is common because the origin and development of the disease is not completely understood.[1][/suP] There is varying terminology and lack of standard diagnostic criteria and this complicates the gathering of accurate information about pulmonary fibrosis.[1][/suP]

    On spirometry, as a restrictive lung disease, both the FEV1 (Forced Expiratory Volume in 1 Second) and FVC (Forced Vital Capacity) are reduced so the FEV1/FVC ratio is normal or even increased in contrast to obstructive lung disease where this ratio is reduced. The values for residual volume and total lung capacity are generally decreased in restrictive lung disease[7][/suP].”

    So, it appears that it's a culmulative diagnosis, based on symptoms, PFTs, high resolution CT scans and confirmation with lung biopsy (a very invasive procedure). As there is no real treatment and so little is known about it…and hearing how poor Eva Holloway had such a rough time after her lung biopsy…I have to wonder why anyone would bother with a lung biopsy (and risking the introduction of more infection) when there is nothing they can do about it, except alleviate symptoms? In a case, where diagnosis is uncertain with imaging and PFTs, I'd personally err on the side of caution and get treated for chronic infection, much as is done for elderly patients with Bronchiectasis with palliative help in serious situations (like oxygen therapy) where needed.

    So…nope, looks like PFTs alone are not definitive for Pulmonary Fibrosis, but may assist in a diagnosis.

    Does that help?

    Peace, Maz

    #345339
    JBJBJB
    Participant

    [user=9]casey[/user] wrote:

    Hi All,

    Can a pulmonary function test alone  tell if one has pulmonary  fibrosis?

    Casey,

    I have restricted lungs which means the bottom of my lungs are badly scarred. I depend on top part of lungs to breath. I went to two university clinical professors to see if I have pulmonary fibrosis. They said I got bronchiectasis. Both fibrosis and bronchiectasis could cause shortness of breath and also low PFT. In addition the distress of lungs could also have low PFT.

    I had to have high resolution lung CT scan. My local pulmonary specialist, graduated from Michigan State, swore by it that I had fibrosis and tried VVVVVVVVVEEEEEEEEEEEEERRRRRRRRRRRRRRRRRRYYYYYYYYYY hard to convince me to do lung biopsy. I told him no way I would do that. When I went to the Northwestern University, the leading expert of SD told me “I am really glad you did not do the biopsy. you don't need it!”

    From what I read, a lot of the time the scar tissues from the biopsy eventually could turn to cancerous tissues. Also the frequent CT scan could cause lung cancer. Statistic shows at least 2% of cancer patients were exposed to frequent CT scans.

    JB

     

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