This had deteriorated progressively since diagnosis in 2009 when the FVC was 2.39 (56%) and DLCO was 4.89 (50%). Lung function demonstrated a severe restrictive deficit with FVC of 1.48 (34%), a 38% decline over a 5-year period and diffusing capacity for carbon monoxide (DLCO) of 3.21 (33%).
Download file into bagpipe player serial#
Serial HRCT images demonstrated progressive ground-glass change and mosaic pattern. Prior to clinic review, the case was reviewed in an ILD multidisciplinary team meeting (MDT). He had been treated with prednisolone 0.5 mg/kg, which had been intermittently tapered to maintain symptomatic stability. He did not take his bagpipes to Australia. As a hobby, he played the bagpipes daily. There was no significant medical history. On returning to the UK, his breathing deteriorated rapidly. He reported that during this time his symptoms rapidly improved and that he was able to walk 10 kilometres on the beach without stopping. His symptoms were insidious and progressive, with the exception of a 3-month period in 2011 when he went to live in Australia. The precipitating trigger for his HP was unknown. His house showed no evidence of mould or water damage, and he had no symptoms of connective tissue disease. He did not have any exposure to birds or pigeons. He had a prior diagnosis since 2009 of HP based on high-resolution CT (HRCT) and biopsy findings from his referring hospital. A 61-year-old man was referred to the interstitial lung disease (ILD) clinic in April 2014 with a 7-year history of dry cough and progressive breathlessness despite immunosuppressive therapy, leading to a reduction in exercise tolerance from over 10 kilometres to 20 metres.
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