Interstitial pneumonia is an inflammation of the interstitial tissue of the lung, and it is not a single disease, but an umbrella term for a complex group of diseases. With interstitial pneumonia, many people tend to confuse it with pulmonary fibrosis and even classify it as an occupational disease like pneumoconiosis. In the treatment of interstitial pneumonia, there is also a misconception that hormones, as the primary treatment for interstitial pneumonia, must be taken for life. Today, Dr. Luo Qun from the Department of Respiratory Medicine of the First Hospital of Guangzhou Medical University was invited to summarize eight misconceptions about interstitial pneumonia to help you see the real interstitial pneumonia. Myth 1: Interstitial pneumonia = pulmonary fibrosis In fact, interstitial pneumonia and pulmonary fibrosis can be two separate events, or they can occur sequentially. Interstitial pneumonia can develop into pulmonary fibrosis, usually with inflammation followed by fibrosis. In this process, some sites can have injury, inflammation, and fibrosis at the same time because the timing of the lesions is inconsistent at different sites. Of course some fibrosis can also change to fibrosis without inflammation, directly from the injury inside the lung. Therefore, interstitial pneumonia cannot be directly equated with pulmonary fibrosis. Myth 2: Interstitial pneumonia is an occupational disease Interstitial pneumonia is not a well-defined occupational disease like pneumoconiosis. While the occurrence of pneumoconiosis is directly related to the environment, there are many causes of interstitial pneumonia; dust exposure is only one of the causes, and medications can also lead to inflammation causing fibrosis. Others, such as rheumatic lung, a specific type of interstitial pneumonia, are caused by autoimmune dysfunction. In addition, the cause, such as idiopathic interstitial pneumonia, is not well understood. It is possible that a combination of factors such as genetic predisposition, environmental pollution, coupled with infection lead to interstitial inflammation, which in turn causes fibrosis. Since the cause-and-effect relationship is not very clear, it cannot simply be said that interstitial pneumonia is an occupational disease. Myth 3: All interstitial pneumonia requires lifelong medication. It is not definitive whether lifelong medication is needed because interstitial pneumonia is a large group of diseases containing more than 200 types, and it is difficult to treat with a single regimen. Some patients relapse as soon as they stop taking the medication, while others are fine for the time being, so it’s up to the individual to determine. However, there is no indication to tell the doctor whether the patient should take the drug for one year or two years, or for life, including some tests done during the treatment period, and there is no clear guidance whether the patient can stop the drug. Myth 4: How can a 1mg hormone dosage be controlled in patients with interstitial pneumonia? After the disease is controlled, the hormone dosage can be gradually reduced, or possibly even maintained with only 1mg. Although a 1mg hormone dosage may seem small, it can achieve disease control in the stable phase. Currently such small dose applications are relatively common abroad, but rare in China. Myth 5: Interstitial pneumonia is an inflammatory disease, so it should be treated with antibiotics In fact, interstitial pneumonia is generally not treated with antibiotics because the disease is not caused by an infection. It is similar to a bump on the head: because there is inflammation inside, it will be edematous, but this inflammation is not caused by an infection, but by a bump, so it does not need to be treated with antibiotics. However, antibiotics are needed for patients with interstitial pneumonia when there are several conditions: 1. When it is difficult to identify an infection from interstitial pneumonia, antibiotic treatment is needed. When the doctor believes that there is no infection, antibiotics can be stopped; 2. When there is no infection but hormone shock therapy is needed, antibiotics are needed in conjunction with antibiotic therapy because the hormone dosage is high and may induce infection and other side effects to occur. The role of antibiotics at this time is preventive, not that the patient is being infected; 3. Interstitial pneumonia co-infection, it is possible to add antibiotics. Myth 6: Immunosuppressants are only used to treat interstitial pneumonia when hormones are ineffective and hormone therapy is preferred. Immunosuppressants, are used mainly when the patient is not sensitive to hormones. In addition, the following three situations also require the use of immunosuppressants: 1, if the patient is dependent on hormones and must use high doses of hormones to be effective, the addition of immunosuppressants can reduce the amount of hormones; 2, the patient is a contraindication to the use of hormones, such as hypertension, diabetes symptoms are very obvious; have serious osteoporosis, fractures, etc.; 3, single drugs have been unable to control, must be combined with drugs to relieve the condition Immunosuppressants are needed when the disease can be relieved. Myth 7: Immunosuppressants, like hormones, must be used for a long time For patients with interstitial pneumonia, immunosuppressants are rarely used for more than 2 years, and can usually be discontinued after more than 1 year of use. However, some patients with severe disease or prone to relapse, the drug dosage can not be reduced, requiring long-term use of drugs. Patients are reminded that whether and how they can discontinue their medication must be done under the guidance of a doctor and cannot be decided without permission. If Western medicine can’t cure it, Chinese medicine may not be able to cure it either.