Low MIP Pulmonary function test- respiratory muscle weakness

Posted by ialogic @ialogic, Mar 5, 2023

Hi, I had a PFT last year showing moderate restriction and repeated with MIP/MEP. MIP is severely low at -37. MEP is 91. CT shows calcified granuloma. My pulmonologist has not recommended any further testing. I have severe cervical stenosis at c6/7 and c1-c5 mild stenosis. Severe orthopnea bipap intolerance. Asked dr for fluoroscopy/sniff test , they don’t know about it. Neurology can’t figure it out. I have mutation in Dync1h1 gene that are likely pathogenic. Not sure where to start. Help!

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My son also has low MIP (-40) in PFT and pediatric pulmonary doesn’t know how to handle it either. I read supine FVC should be next.

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I thought I'd start by spelling out the acronyms in this post.
- Pulmonary function tests (PFTs) are noninvasive tests that show how well the lungs are working. The tests measure lung volume, capacity, rates of flow, and gas exchange.

- Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) are useful tests for assessing respiratory muscle strength that can be performed with relatively simple equipment. They are particularly useful for monitoring patients with known neuromuscular diseases and disorders.

Fellow member @yli130 talked about similar issues in this discussion and may have learned more over the past months:
- Undiagnosed low maximum inhale/exhale pressure: https://connect.mayoclinic.org/discussion/undiagnosed-low-maximum-inhaleexhale-pressure/

@ialogic, have you been diagnosed with a neuromuscular condition? May I ask what led to the pulmonary function tests being ordered?

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The pulmonologist freaked me out by mentioning neuromuscular issue as my mother had some neuromuscular conditions. He ordered it because I had restricted pattern in PFT just after getting covid. I was trying to tell him that covid or flu can even cause the temporary respiratory muscle weakness, which recovers. However I had the test repeated a year later and MIP is still low. I am not sure if the PFT lab did it 3 times like they were supposed to or I did poorly. Pulmonologist did not refer me to neuromuscular or any other specialist to get EMG for example. I did get a negative sniff test but still unsure why MIP is so low. I am south Asian male at 42.

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Like the other poster my issues also got worse after Covid vaccine.

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I’m getting a second opinion as sniff test was normal and emg was fine. Pef is reduced and ratio is reduced as well indicating copd. On Pulmicort and symptoms are so much better. I can finally take a full breath.

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