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Pulmonary Fibrosis

Steroids

12/04/2009

Question:

When a pulmonary fibrosis patient is given 200mg prednisone because even on 15lpm oxygen they still cant breathe how do the steriods work to open up the lungs so air can go through? How long does this therpy usually work after tapering the steroids down stopping at 40mg? Thanks for you time.

Answer:

Patients with idiopathic pulmonary fibrosis who require 15 liters per minute of oxygen are generally in a very advanced stage. Pulmonologists often use high dose corticosteroid medications in this situation on the hope that there is at least a small component of inflammation that may be reversible with steroids. This can sometimes give transient benefit and occasionally may extend life by several days or even weeks.

Usually, however, the steroids have much less effect in this situation and may not have any benefit in most patients. They are often tried in advanced stage idiopathic pulmonary fibrosis on the hopes that the individual is that rare patient who does have some benefit. 

In the case of a different interstitial disease called "acute interstitial pneumonitis", high dose steroids can sometimes result in longer lasting improvement.

For more information:

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Response by:

James N Allen, Jr, MD James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University