Clinical, laboratory and functional dynamics in a patient with pneumoconiosis and secondary pulmonary fibrosis under conditions of antifibrotic therapy

The article presents a clinical case of a patient with pneumoconiosis complicated by the formation of a "cellular lung" on the background of long-term (2023–2026) therapy with nintedanibin combination with bronchodilators. The patient, was born in 1960, had 20 years of experience working under the influence of quartz-containing dust. The diagnosis of pneumoconiosis was established in 2002.

During an examination in 2023, against the background of radiological signs of progressive fibrosis with the formation of a "cellular" lung, there was shortness of breath when walking up to 50 m, a decrease in saturation at rest to 93% with desaturation under load to 70%, a test distance of 270 m after a 6-minute walk, a decrease in FEV1 to 66%, VVC to 82%, lung diffusivity up to 26%, pulmonary hypertension (CDLA 38 mmHg), signs of respiratory failure of the 3rd degree. Against the background of regular therapy with syntedanib, the authors noted positive dynamics: stabilization of saturation at rest (95–97%), decrease in desaturation during physical exertion (up to 90%), increase in the test distance of a 6-minute walk to 365–384 m, increase in FEV1 to 89-99%, VVC to 111%, total vital lung capacity from 76% up to 97%, diffusion capacity up to 34%, reduction of the average pressure in the pulmonary artery to 7–8 mmHg, normalization of ESR and C-reactive protein. According to computed tomography data, the fibrotic process has stabilized with the preservation of the "cellular lung" pattern without a significant increase in changes over 4 years. The side effects of therapy (weight loss, loosening of stools, moderate increase in transaminases) were controlled.

The observation demonstrates the possibility of achieving clinical and functional stabilization in a patient with progressive pneumoconiosis on the background of prolonged antifibrotic therapy, which justifies the expediency of early treatment and regular monitoring.

Contributions:
Serebryakov P.V. — concept and design of the study, writing of the text, final editing and approval of the published version;
Postnikova L.V. — making valuable comments, final editing and approval of the published version;
Buryakina E.A. — collection of primary data, critical revision of the text;
Ishimbaev D.A. — collection of primary data, processing of results, preparation of visual materials, writing of the initial text;
Zolotova M.V. — processing of results, compilation and formatting of tables, writing the initial version of the text;
Slavinskiy A.A. — collection of primary data, preparation of visual materials.

Funding. The study had no funding.

Conflict of interest. The authors declare no conflict of interest.

Received: 06.05.2026 / Accepted: 21.05.2026 / Published: 27.07.2026

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