Andy K. had been managing his pulmonary sarcoidosis with a pulmonologist near his home in New Jersey for 20 years when the doctor shared some unsettling news: He had run out of options for treating Andy’s condition.
“I was going downhill quickly,” the 70-year-old recalls. “My doctor said you either have to go to New York or Philadelphia [for treatment]. His group had a relationship with Temple, so I made an appointment.”
Pulmonary sarcoidosis is an inflammatory disease marked by an immune system overreaction. This faulty response causes clusters of inflamed tissue, called granulomas, to form in the lungs. Granulomas can cause symptoms like chest pain, trouble breathing, coughing, and fatigue.
Sometimes the condition gets better on its own. But for other people, including Andy, it can progressively get worse and cause permanent scarring in the lungs.
Struggling with symptoms
Andy came in for his first appointment with the Temple Lung Center’s Sarcoidosis Program Director Rohit Gupta, MD, in February 2021. At the time, he was so tired and short of breath that even going up a flight of steps was challenging.
“I became depressed because of my limitations,” he says.
Dr. Gupta conducted advanced diagnostic testing to get more information about Andy’s condition. They found that Andy had fibrosis (scarring) and inflammation, as well as pulmonary arterial hypertension, or high blood pressure in the arteries of the lungs. This new condition, which can be life-threatening, was a complication of his pulmonary sarcoidosis. His care team took a comprehensive approach, managing all of his conditions together to support his overall health.
Prior to coming to Temple, Andy’s condition was largely managed with courses of high doses of corticosteroids. The medications would help him breathe more easily for a while. But eventually the symptoms would come back. And he developed side effects like cataracts, which can happen from heavy, long-term steroid use.
Dr. Gupta opted to manage Andy’s lung problems with advanced medications, including pulmonary vasodilators and a steroid-sparing immunosuppressant. He also sent Andy to pulmonary rehabilitation so that Andy could learn exercises to strengthen his lungs and improve his stamina.
The combination dramatically improved his symptoms without intense side effects.
