A 29-Year-Old Woman Comes to the Office Due to 3

A 29-year-old woman comes to the office due to 3 months of worsening exertional dyspnea and nonproductive cough.  The patient says, "I thought the symptoms were from a cold or allergies, but they have not gone away and have gotten worse.  None of the over-the-counter congestion medicines from the pharmacy have helped."  She has also had occasional joint pain and has felt too tired to keep up with her exercise routine of running 5 miles 3 times a week.  She has had no chest pain, palpitations, syncope, or leg edema.  The patient has no chronic medical problems and does not use tobacco, alcohol, or illicit drugs.  Her brother has asthma.  Laboratory results are as follows: Chest radiography is shown in the exhibit.  Pulmonary function testing reveals that FEV1 is 60% of the predicted value, FEV1/FVC is 80%, and diffusion capacity for carbon monoxide is 60% of predicted.  After discussion of a likely diagnosis and possible therapy, the patient asks about long-term prognosis.  Which of the following is the most appropriate response to this patient?

A) Avoidance of triggering agents should help you prevent future recurrences.
B) Most people with your condition develop progressive lung scarring.
C) There is a high possibility that your condition will resolve over time.
D) You are at increased risk for disease complications due to early age of onset.
E) You need lifelong immunosuppressive therapy to prevent lung damage.