- Symptoms 4 years ago
- never smoker
- past medical history of
- DM2, HTN,
- CAD s/p MI (3 stents, ~12 years ago).
- Chest CT – Chronic HP
- Rx Steroids
- lung transplant on 3/31/2023.
- past medical history of
- never smoker
Timeline
Symptoms started in 2020/2021 (subacute and hard to pinpoint)
4/2022 started on high dose prednisone
1/2023 BMC eval: started O2 3lpm with exertion
2/2023 BAL with 217 nucleated cells, CD4:Cd8 0.39, lymphocytes 19%
3/2023 Started cellcept since March 2023, diarrhea every other day or so
- typical hypersensitivity pneumonitis
- coarse reticulation and minimal honeycombing in a random axial distribution with no zonal predominance
- evidence of small airway disease
- compatible with hypersensitivity pneumonitis
- variable pattern and/or distribution of lung fibrosis:
- basal and subpleural predominance
- upper zone predominance
- central or peribronchovascular predominance
- fibrotic ground-glass attenuation seen alone or in association with small airway disease
- variable pattern and/or distribution of lung fibrosis:
- indeterminate for hypersensitivity pneumonitis
- usual interstitial pneumonia (UIP) pattern
- nonspecific interstitial pneumonia (NSIP) pattern
- organizing pneumonia-like pattern
- truly indeterminate findings
b11431