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Tackling Idiopathic Lung Disease in the Black Hills

Jun 21, 2018 06:00AM ● By MED Magazine

Rapid City Pulmonologist Muhammad Alsumrain, MD, is bringing higher level knowledge on a range of complex and rare lung disorders to Regional Health. In 2016, Dr. Alsumrain spent a year pursuing fellowship training in interstitial lung disease and pulmonary vasculitis at the Mayo Clinic, the only institution that offers this unique training as a formal fellowship. We asked him to share his experience, and what it could mean for Black Hills residents, with MED.

MED: What constitutes “interstitial lung disease” and how is it diagnosed?

MA: Interstitial lung disease is subdivided into idiopathic interstitial pneumonia (IIP), drug induced ILD, connective tissue disease associated ILD (CTD-ILD), and ILD associated with environmental exposures such as hypersensitivity pneumonitis or occupational exposure such as pneumoconiosis. In the past, we often had to send patients for surgical lung biopsy to confirm the diagnosis. But with more understanding of the different radiographic findings and ordering the right blood tests, we have been able to decrease the likelihood of needing surgical intervention to make a diagnosis.

MED: How common are these conditions?

MA: The ILD is a wide subject so it is hard to comment in general about the incidence; however,  subtypes like Idiopathic pulmonary fibrosis ( IPF) incidence estimates range from 7 to 16 cases per 100,000. IPF usually occurs in older people. Farmers tend to be prone to a condition called hypersensitivity pneumonitis which is another type of ILD. The  prevalence of granulomatosis with polyangiitis, which is one type of pulmonary vasculitis, is estimated to be 3 in 100,000 in the US. People with connective tissue disease are prone to develop interstitial lung disease more than others.

MED: Why did you decide to pursue additional training in these diseases?

MA: I love the challenge of diagnosing these diseases and I thought I would like to learn more about this specialty. There are very few centers in the world that draw as wide a spectrum of patients with these disorders as Mayo Clinic. I was exposed to a large number of patients with all types of interstitial lung disease and the rare diseases of pulmonary vasculitis such as microscopic polyangiitis and granulomatosis with polyangiitis (Wegener’s disease) and I gained a lot of experience. I also had the opportunity to participate in multiple clinical trials during the training.