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Methotrexate can also lead to pulmonary toxicity (lung damage), although this is fairly uncommon and more commonly it can confound the leukopenia caused by sarcoidosis. [19] Due to these safety concerns it is often recommended that methotrexate is combined with folic acid in order to prevent toxicity. [ 19 ]
Lung transplantation is the only therapeutic option available in severe cases. A lung transplant can improve the patient's quality of life. [30] Immunosuppressive drugs can also be considered. These are sometimes prescribed to slow the processes that lead to fibrosis. Some types of lung fibrosis respond to corticosteroids, such as prednisone. [29]
Figure A shows the location of the lungs and airways in the body. The inset image shows a detailed view of the lung's airways and air sacs in cross-section. Figure B shows fibrosis (scarring) in the lungs. The inset image shows a detailed view of the fibrosis and how it damages the airways and air sacs. [1]
This can lead to parts of the lung having a honeycomb-like appearance. The extrinsic causes result in lung restriction, impaired ventilatory function, and even respiratory failure due to the diseases that effect the lungs ability to create a change in lung volumes during respiration due to the diseases of the systems stated above. [3]
Mild joint involvement can be effectively treated with NSAIDs, hydroxychloroquine, and oral prednisone. [71] [44] [25] Methotrexate has been observed to be useful in more severe cases. [72] If methotrexate is contraindicated, alternative disease-modifying medications for RA, such as leflunomide or azathioprine, may be used. [68]
Over time, generally over the years, the fibrotic scar tissue slowly tightens and thickens, contracting the contents of one or both halves of the chest and reducing the mobility of the ribs. The peel can become deeper than 2 cm. [ 2 ] Within the chest, the lung is compressed and unable to expand (trapped lung), making it vulnerable to collapse ...
In approximately 51–70% of people with this disease, serum IgG4 concentrations are elevated during an acute phase. [ 1 ] [ 2 ] [ 3 ] It is a relapsing-remitting disease associated with a tendency to mass forming, tissue-destructive lesions in multiple sites, with a characteristic histopathological appearance in whichever site is involved.
The differential diagnosis includes other types of lung disease that cause similar symptoms and show similar abnormalities on chest radiographs. Some of these diseases cause fibrosis, scarring or honeycomb change. The most common considerations include: chronic hypersensitivity pneumonitis; non-specific interstitial pneumonia; sarcoidosis