Dr. Schiffman received his B.S. degree with High Honors in biology from Hobart College in 1976. He then moved to Chicago where he studied biochemistry at the University of Illinois, Chicago Circle. He attended Rush Medical College where he received his M.D. degree in 1982 and was elected to the Alpha Omega Alpha Medical Honor Society. He completed his Internal Medicine internship and residency at the University of California, Irvine.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
"Fibrosis" is a term used to refer to scarring, so
pulmonary fibrosis means scarring throughout the lungs. Pulmonary fibrosis can
be caused by many conditions including chronic inflammatory processes (sarcoidosis, Wegener's granulomatosis
), infections, environmental agents (asbestos, silica, exposure to
certain gases), exposure to ionizing radiation (such as radiation therapy to
treat tumors of the chest), chronic conditions (lupus, rheumatoid arthritis),
and certain medications.
In a condition known as hypersensitivity pneumonitis,
fibrosis of the lung can develop following a heightened immune reaction to
inhaled organic dusts or
occupational chemicals. This condition most often results from inhaling dust
contaminated with bacterial, fungal, or animal products.
In some people, chronic pulmonary inflammation and
fibrosis develop without an identifiable cause. Most of these people have a
condition called idiopathic pulmonary fibrosis (IPF) that does not respond to
medical therapy, while some of the other types of fibrosis, such as nonspecific
interstitial pneumonitis (NSIP),
may respond to immune suppressive therapy.
Synonyms (other names) for various types of pulmonary
fibrosis that have been used in the past include chronic interstitial
pneumonitis, Hamman-Rich syndrome, and diffuse fibrosing alveolitis.
What are the causes and symptoms of pulmonary fibrosis?
Symptoms vary depending on the cause of the pulmonary fibrosis. The severity of symptoms and the progression (worsening) of symptoms over time
can vary.
The most common cause, idiopathic pulmonary fibrosis, unfortunately often has slow and relentless progression. Early on, patients often complain of a
dry unexplained cough. Often, slow and insidious onset of shortness of breath can set in. With time, dyspnea (shortness of breath) worsens. Primarily, dyspnea initially occurs only with activity and is often attributed to aging. With time, the dyspnea begins to occur with less and less activity. Eventually, the shortness of breath becomes disabling, limiting all activity and even occurring while sitting still. In rarer cases, the fibrosis can be rapidly progressive, with dyspnea and disability occurring in weeks to months of onset of the disease. This form of pulmonary fibrosis has been referred to as Hamman-Rich
syndrome.
Rheumatoid arthritis is an autoimmune disease that causes chronic inflammation of the joints, the tissue around the joints, as well as other organs in the body. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.
Systemic lupus erythematosus is a condition characterized by chronic inflammation of body tissues caused by autoimmune disease. Lupus can cause disease of the skin, heart, lungs, kidneys, joints, and nervous
system. When only the skin is involved, the condition is called discoid lupus.
When internal organs are involved, the condition is called systemic lupus
erythematosus (SLE).
Sarcoidosis, a disease resulting from chronic inflammation, causes small lumps (granulomas) to develop in a great range of body tissues and can appear in almost any body organ. However, sarcoidosis most often starts in the lungs or lymph nodes.
Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.
Scleroderma is an autoimmune disease of the connective tissue. It is characterized by the formation of scar tissue (fibrosis) in the skin and organs of the body, leading to thickness and firmness of involved areas. Scleroderma is also referred to as systemic sclerosis, and the cause is unknown. Treatment of scleroderma is directed toward the individual features that are most troubling to the patient.
Pulmonary fibrosis is scarring throughout the lungs. Pulmonary fibrosis can be caused by many conditions including chronic inflammatory processes, infections, environmental agents, exposure to ionizing radiation, chronic conditions, and certain medications. Symptoms include shortness of breath, coughing, and diminished exercise tolerance. Treatment options are dependent on the type of pulmonary fibrosis; lung transplant and/or medications are optons.
Interstitial cystitis (IC) is an inflammatory disease of the bladder that can cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. Symptoms of interstitial cystitis may vary among individuals and may even vary with time in the same individual.
Pulmonary hypertension is an abnormal elevation of the pressure in the pulmonary circulation caused by the constriction of the blood vessels that supply blood to the lungs. Shortness of breath and dizziness are symptoms of pulmonary hypertension. Treatment involves diuretics, blood thinners, calcium channel blockers, and using supplemental oxygen to increase blood oxygen levels.
Interstitial lung disease, is a term to describe a certain lung condition. Causes of interstitial lung disease include lung infection, exposure to toxins in the environment (asbestos for example), medications (chemotherapy), radiation therapy, and chronic autoimmune disorders. Common symptoms of interstitial lung disease include a dry cough and shortness of breath. Diagnosis and treatment depend upon the cause of the condition.
Wegener's granulomatosis, a condition that usually affects young or middle-aged adults, is an inflammation of the arteries supplying blood to the sinuses, lungs, and kidneys. Symptoms of Wegener's granulomatosis include bloody sputum, fatigue, weight loss, joint pain, sinusitis, shortness of breath, and fever. Wegener's granulomatosis may be fatal within months without treatment. Treatment aims to stop inflammation with high doses of prednisone and cyclophosphamide.
Asbestos exposure lung disease is divided into three main types, asbestosis (lung scarring caused by asbestos fibers), disease of the lining of the lung (pleural plaques, scarring, or fluid accumulation), and lung cancer. Mesothelioma is cancer of the lining of the lung caused by asbestos exposure. Cancers of the larynx, throat, kidney, esophagus, and gallbladder have been linked to asbestos exposure. Treatment is dependant upon the type of condition related to asbestos exposure.
Hypersensitivity Pneumonitis is an inflammation of the lung caused by small airborne particles such as bacteria, mold, fungi, or inorganic matter. There are two types of hypersensitivity pneumonitis, acute and chronic. Symptoms include fever, chills, cough, shortness of breath, body aches. Examples of hypersensitivity pneumonitis include bagassosis, mushroom worker's disease, sauna taker's disease, pigeon breeder's disease, and farmer's lung disease. Most commonly, it results from exposure to pet birds.
The lungs are primarily responsible for the exchange of oxygen and carbon dioxide between the air we breathe and the blood. Eliminating carbon dioxide from the blood is important, because as it builds up in the blood, headaches, drowsiness, coma, and eventually death may occur. The air we breathe in (inhalation) is warmed, humidified, and cleaned by the nose and the lungs.
Severe acute respiratory syndrome (SARS) is a respiratory disease caused by the coronavirus SARS-CoV. Symptoms include fever and shortness of breath. Patients with SARS often require oxygen and severe cases require mechanical ventilation.
What is hypersensitivity pneumonitis and what
causes it?
Hypersensitivity pneumonitis is an inflammation of the
lung (usually of the very small airways) caused by the body's immune
reaction to small air-borne
particles. These particles can be bacteria, mold, fungi, or even
inorganic matter.
What is acute hypersensitivity pneumonitis?
Acute hypersensitivity pneumonitis tends to occur 4-12 hours after exposure (usually heavy exposure) to the particles.
What are the symptoms of acute hypersensitivity pneumonitis?
Symptoms of acute hypersensitivity pneumonitis include:
fever,
chills,
coughing,
shortness of breath,
body aches, etc.
Chest x-rays may show diffuse small nodules in the lungs. Typically, the symptoms will subside hours to days after exposure (provided there are no repeated exposures). The Chest x-ray abnormalities w...