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Can Prednisone Help Cure Hypersensitivity Pneumonitis?
Question: xxxxxxxxxxIf treatment is not given for (1.5 years) for someone with chronic hypersensitive pneumonitis (ie fibrosing) and they are still presumed to be under the influence of an unknown antigen, to what extent could we expect deterioration of the patient. In my Mother's situation this corresponded to 11% reduction in vital capacity, plus vastly reduced mobility. Ie. at the start of the non-treatment period Mum was able to climb stairs and after 1.5 years the dyspnea was considerable and she was not able to climb stairs and later on was on a wheel chair. The treatment (ie prednislone) started after 1.5 years subsequent to an HRCT scan which showed fibrosis and the disease. My question is if the prednislone could have started on seeing the fibrosis could Mum's deterioration have been halted or decreased such that she wouldn't be in a wheel chair now.
Brief Answer:
Prednisone is not always 100% effective.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Hypersensitivity pneumonitis (HP) is mostly due to chronic exposure of antigen. Antigen can be anything and any substance.
So the best treatment of HP is early detection of HP and identification of causative antigen. Once causative antigen is identified and removed completely, prognosis is excellent.
But this is true only for early HP.
Once HP progressed and start showing fibrosis, honeycombing etc then even after stopping of antigen exposure, prognosis is poor.
This is true for prednisone also.
Prednisone alone has no role in early HP.
But Prednisone with avoidance of antigen has proven role in early HP. But again improvement is not same for all cases. Some patients improve drastically and become normal, while some still have fibrosis. And few patients still deteriorate further with progressive fibrosis and honeycombing.
Once HP is in chronic stage (like your mother's case), prednisone is given to slow down the progression of disease. By no means prednisone will revert the fibrosis and lung condition.
Again identification of causative antigen and complete avoidance of it are utmost important in chronic HP too.
So, in any stage of HP, avoidance of causative antigen is most important.
Since your mother is still having exposure (presumably), prednisone 1.5 years back would not made much difference in current condition.
Even if she was given prednisone since 1.5 years, deterioration would not be halted or decreased because she is still having that exposure.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your mother. Thanks.
Prednisone is not always 100% effective.
Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.
Hypersensitivity pneumonitis (HP) is mostly due to chronic exposure of antigen. Antigen can be anything and any substance.
So the best treatment of HP is early detection of HP and identification of causative antigen. Once causative antigen is identified and removed completely, prognosis is excellent.
But this is true only for early HP.
Once HP progressed and start showing fibrosis, honeycombing etc then even after stopping of antigen exposure, prognosis is poor.
This is true for prednisone also.
Prednisone alone has no role in early HP.
But Prednisone with avoidance of antigen has proven role in early HP. But again improvement is not same for all cases. Some patients improve drastically and become normal, while some still have fibrosis. And few patients still deteriorate further with progressive fibrosis and honeycombing.
Once HP is in chronic stage (like your mother's case), prednisone is given to slow down the progression of disease. By no means prednisone will revert the fibrosis and lung condition.
Again identification of causative antigen and complete avoidance of it are utmost important in chronic HP too.
So, in any stage of HP, avoidance of causative antigen is most important.
Since your mother is still having exposure (presumably), prednisone 1.5 years back would not made much difference in current condition.
Even if she was given prednisone since 1.5 years, deterioration would not be halted or decreased because she is still having that exposure.
Hope I have solved your query.
I will be happy to help you further.
Wishing good health to your mother. Thanks.
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Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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