ETS Meeting ILD Monthly Webinar – Boehringer Ingelheim
ETS Meeting: ILD Monthly Webinar
Under the sponsorship of Boehringer Ingelheim, one of the world’s largest and family-owned pharmaceuticals and in collaboration with the Emirates Thoracic Society, a reputed organization of scientific meetings, have hosted the Interstitial Lung Disease (ILD) Monthly Webinar on Monday, December 21, 2020, reaping a total of 225 delegates across the world.
Last month, we’ve covered a very illuminating discussion about this disease with experts who were very prominent in this event. Now, in its new chapter, we’re introduced to new developments, treatments, clinical cases, and radiological analysis with additional new speakers to helm the virtual conference.
According to Cleveland Clinic, Interstitial lung disease (ILD) is another term for pulmonary fibrosis, which means “scarring” and “inflammation” of the interstitium (the tissue that surrounds the lung’s air sacs, blood vessels, and airways). This scarring makes the lung tissue stiff, which can make breathing difficult.
Dr. Saniya Khan, Webinar Chairman, Staff Physician of Pulmonology Respiratory Institute, has started a brief welcome message to officially start the agenda as planned.
Dr. Rohit Pradhann, Specialist Pulmonary Disease of Zayed Military Hospital, presenting Case 1: ILD of a young woman with chronic progressive dyspnea, provided an in-depth analysis with regards to the features of the HRCT chest. He also aimed to understand the current therapeutic options, including the role of an immunosuppressant. In summary, it is a case of gradually progressing cough and dyspnea leading to hypoxemic respiratory failure due to chronic fibrosing interstitial pneumonia with possible fibrotic hypersensitivity pneumonitis or nonspecific interstitial pneumonia (NSIP) (idiopathic). Responding to systemic steroids which requires Steroid sparing, immunosuppressive agent to minimize side effects and achieve optimum management.
Prof. Ashraf Alzaabi, President of the Emirates Thoracic Society and Head of Respiratory Division at Zayed Military Hospital, has also shared his observation in which he argues that history-wise she (patient) had a strong exposure. He complimented the findings of the so-called “squeaking sound” based on Dr. Rohit’s presentation in which back in the 70s(?) he has read about one patient with this very unusual sound that’s called squeaking.
Supporting altogether these complex ILD cases, Dr. Mahmoud El-Kaissi, Staff Physician, Diagnostic Radiology of Cleveland Clinic Abu Dhabi, has poured out his brilliant remarks by sharing his critical evaluations as previously presented by Dr. Rohit, respectively. On his observations, he utilizes the radiological images to better analyze the issue of ILD from clinical files spanning across diverse ILD cases. Further, he commented that “Sarcoidosis is an excellent differential diagnosis especially that it also goes into the upper lobe.”
Dr. Fabrizio Facchini, Consultant Pulmonologist at Tawan Hospital, has contributed his very well thought observations in which he muses, “I would have considered also LIP because they use a significant amount of round glass. I was wondering if there are cystic around especially in the lower lobes. I’ve seen the walking test and the drop of oxygenation. There are some recommendations about stopping the walking test a little bit early.”
Dr. Youssef Dairi, Consultant Pulmonologist of Rashid Hospital, UAE on his topic of Case 2: Work Up for Suspected ILDs has aimed to review the spectrum of ILD, identify the clues on presentation to make the diagnosis, review the common radiographic findings in ILD, and study an algorithm to make the diagnosis. By scientific definition, ILD is characterized by cellular proliferation, interstitial inflammation, fibrosis, or a combination of such findings within the alveolar wall that is not due to infection or cancer. He also argues that treatment choices and prognosis vary among different types of ILDs. In a nutshell, RCT is essential in establishing the diagnosis or directing further without a detailed history of environmental exposures, medications, or symptoms suggestive of connective tissue disease is needed.
Dr. Sharina Aldhaheri, Consultant Pulmonologist of Tawam Hospital has discussed Case 3: Pulmonary Fibrosis and COVID-19. She underlined the risk factor of the COVID-19 for patients with pulmonary fibrosis. In her clinical study, she cited an example of a non-smoker 83-year-old-man with progressive fibrotic ILD. As the patient case progressed in 2020, Dr. Sharina has endorsed Oxygen Therapy to better find clinical analysis and interpret the ILD case. Relevant radiological images have also been observed by Dr. Mahmoud. It was also confirmed that the patient has a negative COVID result which leads to more investigation considering fibrosis and vascular complications. Dr. Mahmoud then adds, “Probably he has an exacerbation of his ILD triggered probably the infections. So now a different factor is contributing to the worsening of his disease.” Ergo, patients with ILD are at increased risk of death from COVID-19, particularly those with poor lung function and obesity.
Dr. Saniya Khan, after giving a complimentary reaction to Dr. Sharina’s comprehensive analysis, provided a hopeful message to end the webinar in which she adds, “Time will tell if the COVID vaccine will be required vaccination for widespread use for years to come and in that situation, we are probably along with influenza and pneumonia vaccination are going to require COVID vaccination prior ILD population as well.”
The Interstitial Lung Disease is an essential monthly meeting that aims to provide the latest medical analysis especially in the time of the COVID-19 pandemic. Revisit previous ILD webinars through our official YouTube Channel: https://www.youtube.com/channel/UCmhQ2sapyUtQk9zIpiZCPkg/featured and check our website at https://mco.ae/events/ for all upcoming events!