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Progressive pulmonary fibrosis — SCE Respiratory MCQ

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HardILDProgressive pulmonary fibrosisSCE Respiratory

A 69-year-old woman with rheumatoid arthritis-associated fibrotic ILD has worsening breathlessness over 18 months despite stable joint disease. FVC has fallen from 2.4 L to 2.0 L and HRCT shows increasing traction bronchiectasis. Infection and heart failure have been excluded. What is the most appropriate management?

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Correct answer: E — Discuss antifibrotic therapy for progressive pulmonary fibrosis

Physiological decline and radiological progression despite management of the underlying CTD indicate progressive pulmonary fibrosis, where antifibrotic therapy may be considered in specialist ILD care. Controlled joint symptoms do not exclude lung progression. Bronchodilators and pleural aspiration do not address fibrotic progression.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/