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Thursday, June 20, 2013
Questions About Pulmonary Fibrosis
Would the dlco test being low, be something significant? I have had pulse ox, chest xray, echo, cardiac MRI all normal. This is the first test that has come back positive. I have had sob a cough that feels like it is coming from gerd. The pulmonologist told me "I really don`t think it`s pulmonary fibrosis or an other interstitial lung disease." he also said that with my negative echo, cardiac MRI, he does not believe it is pulmonary hypertension. He said it`s anxiety! Can anxiety cause a decreased DLCO test? I am in my mid twenties. I had a ct scan 4 years ago, does pulmonary fibrosis come this fast? Thanks
When the rest of the pulmonary function tests are normal, a low diffusing capacity can be a sign of interstitial lung disease or pulmonary hypertension. However, there are other conditions that can cause the diffusing capacity to be low as well, and these need to be excluded first.
Anemia will cause the diffusing capacity to be low. Taking a small breath during the diffusing capacity maneuver will also make the diffusing capacity to appear low - this can be adjusted for by looking at the "DLCO/VA" which means the diffusing capacity divided by the total lung volume. Anxiety does not cause a low diffusing capacity unless the anxiety results in an inadequate breath during the diffusing capacity test.
Pulmonary fibrosis can develop over a 4 year period, but it is very rare in persons in their mid-20's.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University