A 70-year-old man with a history of hypertension comes to the physician for shortness of breath with mild exertion, progressive weakness, and a dry cough that has persisted for 6 months. He has smoked a pack of cigarettes daily for 45 years. His medications include enalapril. His pulse is 85/min and irregularly irregular. Physical examination shows enlarged fingertips and markedly curved nails. A CT scan of the chest shows clustered air spaces and reticular opacities in the basal parts of the lung. The patient undergoes lung biopsy; histologic examination shows areas of interstitial inflammation, foci of proliferating fibroblasts, dense collagen fibrosis, and honeycomb change. Pharmacotherapy aimed at which of the following is most helpful in treating this patient's lung condition?

Question

Quizplus · Accepted Answer

Eductional Objective: Excess collagen deposition in the extracellular matrix of the lung is the underlying mechanism of this patient's interstitial lung disease. Diffuse thickening of the alveolar walls results in progressive fibrosis of the lung parenchyma, which in turn causes reduced vital capacity, and the dyspnea, chronic dry cough, and fatigue seen in this patient. Therapies are directed at slowing the progression of fibrosis by inhibiting transforming growth factor-beta and other fibrogenic growth factors (eg, PDGF, fibroblastic growth factor, and VEGF).

A 70-Year-Old Man with a History of Hypertension Comes to the Physician