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In this webinar on interstitial lung disease, Cassie Kennedy, M.D., Transplant Pulmonologist, and Teng Moua, M.D., Interstitial Lung Disease Clinic Director, discuss interstitial lung disease symptoms, diagnosis, and treatment options, including lung transplantation. Questions were answered following the presentation.
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Thank you, very informative webinar.
Can the beta blocker Corgard (nadalol) cause lung scarring? Diagnosed with chronic bronchitis (copd) and have taken Corgard 30 years for LGL heart syndrome. Can't take many of the bronchodilators due to the syndrome and meds.
Joni, Dr. Moua had this to say: Indeed NSIP is often believed to be related to rheumatologic disease (there are 7 commonly known to be associated with interstitial lung disease) of which joint symptoms are common. Sometimes it is difficult to initially diagnose associated rheumatologic disease because of vague or nonspecific symptoms and blood studies. In about 20-30% of patients, interstitial lung disease presents before subsequent rheumatologic disease. In that regard, complete rule out of rheumatologic disease may not be definite yet. With time and close follow-up, this may become the case. As for joint pain being secondary to prednisone withdrawal, I suspect pain was there before prednisone use (?). If inflammatory in nature, joint pain should have gotten better on steroids, and perhaps taking away steroids may make pain come back, but is not a known side-effect of prednisone withdrawal.
From Dr. Moua: If there is concern for low oxygen, care should be taken with more rigorous activity, with oxygen support if needed. This would be inclusive of snorkeling or airplane traveling given the changes in oxygen and atmospheric pressures. Otherwise, singing, exercising, walking, and daily activities should be performed as much as tolerated to maintain good conditioning, with the support of oxygen where needed.
From Dr. Moua: I have not had experience with nadolol or other beta blockers causing a common or recognized form of lung injury or chronic lung scarring. A search of the literature suggests a phenomenon of ‘lung allergy’ or hypersensitivity pneumonitis, though it’s unknown as to its long term scarring or fibrosis. There are many other causes of lung scarring, including some associated with COPD or smoking, as well as occupational or environmental exposures. So, these should be reviewed carefully first before concluding that nadolol is contributory to lung scarring as it may be helpful or needed for your heart condition.
Sure. The URL is http://www.pneumotox.com/.
From Dr. Kennedy: There is some published evidence that the average survival of a patient that is 71 would be less than that of patients under 40 following lung transplant. However, if the patient is in otherwise good health transplant may still be considered a good option for those with an otherwise low life expectancy or poor quality of life.
From Dr. Kennedy: Medications differ by program, but the standard regimen usually includes one of each of three classes of medications:
1) Calcineurin inhibitors (cyclosporine or tacrolimus) or mTor inhibitor (sirolimus)
2) Steroid (Prednisone)
3) Antimetabolite (azathioprine or mycophenolate mofetil)
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***URGENT*** My 55 year cousin is battling her second bout with BOOP. She was put on hospice about a week ago. Is this disease in the same category as Interstitial Lung Disease. Are patients with BOOP good candidate for heart/lung transplant? Is it too late to try to get her an appointment at Mayo?