In the further course of the disease, the before diagnosed subacute HP progressed to chronic HP (MSCT scan).
Five years later, the following therapies were recommended:
- Ambulatory rehabilitation (“lung sports”)
- Vaccination against pneumococci and influenza
- Immunosuppressive therapy with azathioprine, prednisolone and N-acetyl cysteine.
combination therapy led to some clinical improvement and to a
significant improvement in lung function (FVC increase of absolute 18%;
+500 ml) after three months. Due to side effects, this immunosuppressive
therapy had to be terminated at that time.
months later, another clinical deterioration was accompanied by a
decrease in pulmonary function again, resulting in immunosuppressive
therapy with intravenous cyclophosphamide.