Do you work in a dusty workplace or are you exposed to chemicals through inhalation? You have long-lasting shortness of breath, but nothing can be detected in the tests? An occupational disease or pulmonary fibrosis may be developing. You'd better go to a pulmonologist.
The area around the air sacs (alveoli) in the lungs is called the interstitium. Dust, gas, minerals, microbes or allergens that can cause lung damage may cause hardening (callousing), which we call fibrosis, in this area. The most common causes are dust and minerals encountered occupationally or environmentally. The most common occupational groups are ceramics and porcelain factory workers, glass workers, textile workers, coal mine workers and stone crushers. It can rarely be seen in painters, bakers and hairdressers. Fibrosis also occurs in diseases called Sarcoidosis and IPF.
Respiratory distress and dry cough, which increase with exertion, are the most prominent complaints. Chest radiography and especially thin-section lung tomography give very important clues regarding diagnosis. Respiratory function tests also show dysfunction that we call restrictive loss, which is seen in diseases that prevent the lung from expanding. Patients' detailed occupational history, hobbies, medications used, time and duration of complaints, whether they benefited from treatments, and additional diseases should be questioned in detail. Because lung involvement may occur during some rheumatic diseases, and fibrosis may develop as a side effect of medications. During physical examination, rales can be heard in the lungs, clubbing in the fingers may occur, and examination findings may be added depending on additional disease.
Laboratory findings may include anemia, increased sedimentation, and some positive rheumatism tests. Pulmonary function tests (PFT) and diffusion test are also important in diagnosis. Diagnosis can be made in most cases with a good history, PFT and standard imaging tests. In a small subgroup, some additional advanced tests such as biopsy and bronchial lavage may be required.
The main aim of the treatment is to reveal the cause, get rid of it and prevent the progression of the disease. Depending on the patient's complaints, corticosteroids, cytostatic drugs and Supportive treatments can be applied. Sometimes a lung transplant, which we call transplantation, may be required.
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