What is lung scaring?

We are talking about a condition in which, due to various causes, the lungs are damaged at alveolar level, leaving scars that affect respiratory capacity, since the hardened scar tissue prevents these organs from performing their function properly, and when it is not diagnosed or treated in time, the condition progresses making symptoms worse and breathing increasingly difficult. 

So far it has not been possible to identify a direct cause of this disease. Due to this, it is called idiopathic lung scaring.

Risk factors include exposure to polluting and toxic substances, certain drugs, having received radiotherapy or chemotherapy, smoking, and some conditions such as:  

• Sarcoidosis.
• Polymyositis and dermatomyositis.
• Scleroderma.
• Pneumonia.
• Lupus.
• Arthritis.
• Gastroesophageal reflux.

Lung lesions caused by it cannot be reversed, so treatment is focused on improving the patient’s symptoms and quality of life, although in cases where the damage is severe, a lung transplant is required to restore lung function.

The typical symptoms depend on the degree of progression of the disease and the severity of the injuries caused by it:

• Breathing problems.
• Coughing fits.
• Tiredness and weakness.
• Weight loss.
• Muscle and joint pain. 

Lung scaring can progress rapidly or remain stagnant for years, but if not treated properly, it can lead to serious complications such as: 

• Heart and respiratory failure.
• Pulmonary hypertension.
• High risk of developing lung cancer. 
• Blood clots and lung infections. 

Once your doctor analyzes your symptoms and medical history, it will ask you if you have been exposed to toxic substances and will perform a physical examination, where it will listen to your lungs to determine if you are breathing normally or have difficulties. 

In case of suspecting that it is lung scaring, it will request a series of imaging studies such as X-rays, echocardiography, and computed tomography to corroborate the diagnosis and rule out any other condition.

Also, it will ask you for pulmonary function tests to determine the degree of involvement and the capacity of your lungs, an oximetry to measure your oxygen level, a stress test with the purpose of monitoring lung work before physical activity.

If the above tests are inconclusive, a lung tissue biopsy will be analyzed in the laboratory. This sample can be extracted in several ways:

• Bronchoscopy: A bronchoscope, which is a thin catheter, is inserted through the nose or mouth that removes small samples that sometimes are not enough to obtain definitive results. The advantage is that it is minimally invasive and low risk.
• Surgical procedure: when a large sample is required to make an accurate diagnose, surgery is the best alternative. It can be carried out with minimally invasive procedures or by open technique, the latter being riskier. 

There is no treatment to cure lung scaring or to reverse the damage caused, so therapy focuses on controlling symptoms, slowing their progression as much as possible, and improving the patient’s quality of life. 

The treatment plan usually includes specialized drugs to stop scaring and others to control symptoms, oxygen therapy, and pulmonary rehabilitation exercises.

If none of this works, and the patient’s lung capacity is very low, the only option is a lung transplant, which implies a high risk for the patient.

In the Saludora Medical Center Internal Medicine Department, we offer you health care services with the highest quality and safety, from the prevention, diagnosis, timely treatment, and monitoring of infectious, respiratory, endocrinological, dermatological, rheumatic, nephrological, gastrointestinal, and hematological pathologies, from both chronic-degenerative diseases and acute conditions, through a comprehensive and multidisciplinary model.

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