Steroid therapy in pulmonary fibroses

Abstract

1. The value of steroid therapy in non-tuberculous pulmonary fibroses and infiltrations is examined in the light of personal experience and the published reports of other workers. 2. Pulmonary sarcoidosis responds well in its earlier stages and steroid therapy should be employed in all patients with respiratory symptoms or with progressive or persistent lung lesions. Permanent maintenance therapy is necessary to avoid relapse. 3. Radiation lung damage in the pneumonitis stage appears to respond to steroid therapy and three months' treatment is suggested for all such cases. Long-standing fibrosis shows no response and corticoids are not thought to have any prophylactic value. 4. The Hamman Rich syndrome is unlikely to respond to steroid therapy, but no other treatment can be offered. 5. The pleural lesions of systemic lupus erythematosus respond dramatically to steroid therapy. The interstitial pneumonitis occurring in this disease shows a less satisfactory response, but both lung and pleural lesions should always be treated with corticoids. Permanent maintenance therapy is required to avoid relapse. 6. The lung lesions of scleroderma are unlikely to be improved by steroid therapy.