Hello XXXXXXX

Thanks for posting your query along with all the investigation reports and details of treatment taken so far.

I have gone through all of them minutely. Your aunt has undergone extensive investigations. Invetigations reveal that her ESR is raised, she may be suffering from sinusitis, chest x XXXXXXX reveal that she has nonspecific pneumonitis and HRCT suggest that she could be suffering from mild ILD/NSIP/IPF. All other investigations are normal.

However you have not mentioned her symptoms and their severity. No PFT/Diffusion capacity report is found attached which may tell us about the severity of her illness. From her HRCT findings it appears that her disease is of mild to moderate severity but then she has been prescribed low dose oxygen in her last two prescriptions. Though from all the investigations it appears to be ILD, but to confirm the diagnosis, a tissue diagnosis is must which can be obtained by bronchoscopy.

Her line of management is more or less on the standard regimen. I will suggest that she should use her inhalers especially like seroflo/seretide regularly. Recurrent chest infections should be avoided and she should do some deep breathing exercises and some form of exercise to improve her lung capacity. She should avoid dust, smoke extreme cold weather and dry cold air. If her symptoms are progressive, she should be on long term oral steroids(titrated to min effective dose) and low dose oxygen therapy.

It`s generally a progressive disease but rate of progression varies in different individuals and patient`s symptoms can be kept under control for long period of time if above measures are followed religiously.

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Thank you XXXXXXX

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Hello XXXXXXX

Thanks for posting further inputs on XXXXXXX but these are not the tests asked by me. I had asked for a PFT to know the severity of her symtoms/disease and a lung biopsy report. However, i feel there is no need to subject her to more tests as it will inconvenience her further and the diagnosis appears to be DLPD based on all other investigations. The treatment she is getting is on the correct line. I will suggest that in view of her skin lesions, you may consult a rheumatologist also.

Take care.

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