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Have lupus. Diagnosed small airway disease not asthma. Lung volumes show significantly decreased functional residual capacity. Menaing?

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Allergist and Immunologist
Practicing since : 1999
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I have some questions regarding PFT's and my doctor really confused me. He said my results showed small airway disease NOT asthma!? I am so confused??? so do I have interstiual lung disease or scarring in the lungs??? because it does say my lung volumes show significantly decreased functional residual capacity , but otherwise normal . I am afraid because I have lupus that its destroying my lungs! please help me understand what the doctor said I am so scared. he just told me to f/u in 6 months, I also have had a clear chest xray. I just dont understanad what he said- he also said he didnt want to treat me right now because i have inhaler will just increase my heart rate more

my results say this "spirometry showed a forced vital capacity of 3.5 L which is 95% of predicted and FEV1 2.8L which is 96% of predicted FEV1/FVC is 81% The mid flow rates are moderately decreased. Significant improvement seen in mid flow rates with bronchodilator.

The lung volume shows normal vital capacity and total lung capacity . The functional residual capacity is severely impaired.

The diffusion is mildly impaired but when corrected to alveolar volume it is normal.

Conclusion.
1. spirometry and flow volume loop show small airway disease; significant improvement seen in mid flow rates with administration of bronchodilators
2.lung volumes show significantly decreased fuctional residual capacity , but otherwise normal
3. The diffusion is mildly impaired, but when corrected to aleveolar volume it is normal
Posted Thu, 10 Oct 2013 in Lung and Chest disorders
 
 
Answered by Dr. Sujoy Khan 48 minutes later
Brief Answer:
Small airway disease, low FRC occ.feature of lupus

Detailed Answer:
Hello XXXXXXX

Welcome to Healthcare Magic and thank you for writing to us.

Lupus is a multisystem disease and occasionally the lungs are not spared. You tend to lose the lung volumes, (Chest X XXXXXXX shows small lungs), then decreased oxygenation (as seen in diffusion capacity, or DLCO).
You may have asthma/COPD on top of this or in isolation but as bronchodilators are having a good effect, I would suggest you discuss this again with your doctor to prescribe you one, especially if you feel short of breath.
POTS is not a contraindication to bronchodilator use, but depending on the choice of the inhaler, you should be fine.

The good news for you is that the lung volumes are good, diffusion capacity when corrected to alveolar vlume (DLCO corr AV) is normal, which means oxygenation is good.

Keep the lupus under control. This is not suggestive of ILD.


Best Wishes.
Above answer was peer-reviewed by
 
Follow-up: Have lupus. Diagnosed small airway disease not asthma. Lung volumes show significantly decreased functional residual capacity. Menaing? 3 minutes later
So having the low FRC does this mean I will develop lung scarring? I am Very concerned. I am only 27. how can I stop this from happening? My chest Xrays are clear.

so do i have COPD/Asthma
or is lupus destroying my lungs? im very confused

it says my diffussion is good and my pulse ox is always good :/ i dont knwo what to do
 
 
Answered by Dr. Sujoy Khan 58 minutes later
Brief Answer:
FRC is compliance of lung and chest wall

Detailed Answer:
The functional residual capacity is what remains in the lung at the end of a normal expiration. This is determined by the compliance of the lung and chest wall.
See more here:
WWW.WWWW.WW
A low FRC is not indicative of development of lung scarring.
Normal DLCO is good, so lupus has NOT destroyed your lungs.
A good response to bronchodilators usually indicates reversible airway disease, as seen in asthma.
Hence, my suggestion to go for combination inhalers (steroids + long acting beta agonists).

Best Wishes.
Above answer was peer-reviewed by
 
Follow-up: Have lupus. Diagnosed small airway disease not asthma. Lung volumes show significantly decreased functional residual capacity. Menaing? 3 minutes later
Thank you so much. Now I understand more- I am going to go see an Allergist Friday and in the midst of getting a 2nd opinion with a lung doctor. or do you think allergy/immunology can help me too ?
 
 
Answered by Dr. Sujoy Khan 5 minutes later
Brief Answer:
Yes, a 2nd opinion plus Allergy opinion is reqd

Detailed Answer:
Yes, I would think discussing the pros and cons of various lung medications is required plus checking the current list of medications you are now on.

Allergy/Immunology will help you understand if fungal or mold allergies are causing the asthma, in which case identifying and treating this (plus avoidance) will help the airways.

Best Wishes.
Above answer was peer-reviewed by
 
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