When do you start steroids for radiation pneumonitis?

Great question on a relevant clinical topic. It's very important to remember that pneumonitis is a diagnosis of exclusion. Sometimes, if the timing is right and the patient's presentation is typical, there is a tendency to move quickly to the conclusion that the symptoms are caused by pneumonitis. R...

I usually start steroids soon, when symptoms develop, if the symptoms are severe. I will give a trial of antibiotics if I think there is possibly an infection. But if there is no fever or colored sputum and no infiltrate on chest X Ray, I go right to steroids. If they are very symptomatic and I am w...

I woud start prednisone in any patient with clinical evidence of radiation pneumonopathy where SOB is not atributed to a worsening of their COPD for instance. In the case outlined here, the patient's SOB may be related to underlying lung disease and not radiation effect. If the pulmonologist is unco...