Idiopathic pulmonary fibrosis diagnostic study of choice: Difference between revisions
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Revision as of 12:59, 2 April 2018
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Idiopathic pulmonary fibrosis Microchapters |
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Differentiating Idiopathic pulmonary fibrosis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Criteria
The diagnosis of IPF can be made by demonstrating UIP pattern on lung biopsy in a patient without clinical features suggesting an alternate diagnosis (see clinical features, above). Establishing the diagnosis of IPF without a lung biopsy has been shown to be reliable when expert clinicians and radiologists concur that the presenting features are typical of IPF.[1] Based on this evidence, the 2002 ATS/ERS Multidisciplinary Consensus Statement on the Idiopathic Interstitial Pneumonias proposes the following criteria for establishing the diagnosis of IPF without a lung biopsy:
Major criteria (all 4 required):
- Exclusion of other known causes of interstitial lung disease (drugs, exposures, connective tissue diseases)
- Abnormal pulmonary function tests with evidence of restriction (reduced vital capacity) and impaired gas exchange (pO2, p(A-a)O2, DLCO)
- Bibasilar reticular abnormalities with minimal ground glass on high-resolution CT scans
- Transbronchial lung biopsy or bronchoalveolar lavage (BAL) showing no features to support an alternative diagnosis
Minor criteria (3 of 4 required):
- Age > 50
- Insidious onset of otherwise unexplained exertional dyspnea
- Duration of illness > 3 months
- Bibasilar inspiratory crackles
References
- ↑ Flaherty, Kevin R. (2004). "Idiopathic interstitial pneumonia: what is the effect of a multidisciplinary approach to diagnosis?". American Journal of Respiratory and Critical Care Medicine. 170: 904–10. Unknown parameter
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