Question: Hi. I have an asthma history but since I moved to the US three years ago I did not have a single problem. Then, after three years I changed apartment and experienced breathing difficulties and chest stiffness / pressure. It's been 2 months and it does not go away much though symptoms vary. The most common is chest stiffness even without breathing difficulties. It feels totally different to the asthma I remember.
I had PFT and it resulted as follows:
Pre-bronchodilator: FVC 78% of predicted (LLN: 70%), FEV1: 90% Predicted, FEV25-75 103% predicted
Post-bronchodilator: FVC 88% , FEV1 100%, FEV25-75 134%
In the new apartment I started feeling this, there was Aspergillus in one of the air samples (from the socket from the other apartment) yet it was not niger nor fumigatus and the count was still way below the sick air threshold (220, they consider borderline value from 800 upwards)
I suspect some sort of ILD, possibly hypersensitivity pneumonitis (light option) or IPF (worst option)
My chest Xray went out totally clean.

Please voice your opinion on the above. Thank you.

Hello Dr Jolanda,

Thank you for your reply. My allergist has put me on a combined ICS with LABA, however I feel pretty jittery after it so I switched to Alvesco, the pro-steroid seems OK. I started it on Thursday, Friday and Saturday I felt quite oK, today I am short in breath again and there is this enormous pressure over my chest. My heart is very much OK, I exercise, run etc.

I thought about Aspergillus but I had moved from this Aspergillus-affected apt more than one month ago. Additionally, I had the full profile of allergic reponses tested, Aspergillus is one of the very few things I show no sensitivity to, whatsoever. Same applied to other mold.

I would like to ask why do you think it is not ILD? I wanted to add that I have very high FEV1/FVC (above 100% pre-med) which together with low FVC speaks of restrictive LD, right?

Of the other symptoms, I do not cough at all, have no fever and - which is rather strange given the short breath - I do not wheeze at all.

Why do you think I do not have ILD?
And question number 2 - if I have hypersensitivity pneumonitis and let's say it satrted two months ago - how long does it take to develop fibrosing scarrs?

Thank you!