Idiopathic interstitial pneumonia diagnosis

Idiopathic Interstitial Pneumonia Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Idiopathic interstitial pneumonia from other Diseases
Epidemiology and Demographics
Risk Factors
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
History and Symptoms
Physical Examination
Laboratory Findings
CT
Endoscopy
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Idiopathic interstitial pneumonia diagnosis On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Idiopathic interstitial pneumonia diagnosis All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA onIdiopathic interstitial pneumonia diagnosis
CDC on Idiopathic interstitial pneumonia diagnosis
Idiopathic interstitial pneumonia diagnosisin the news
on Idiopathic interstitial pneumonia diagnosis
Directions to Hospitals Treating Idiopathic interstitial pneumonia
Risk calculators and risk factors for Idiopathic interstitial pneumonia diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Ahmed Zaghw, M.D. [2]; Chetan Lokhande, M.B.B.S [3]

Overview

Repeated measurements of different clinical and physiological parameters are believed to be useful in assessing the clinical course of IPF. Assessment of dyspnea, using an established clinical scale for rating the impact of dyspnea on activities. Lung volumes, DLCO, resting arterial blood gases, cardiopulmonary exercise testing with measurement of gas exchange, HRCT lung scans are our current tools for diagnosing idiopathic interstitial pneumonia. Physiologic testings have been used to determine the current functional lung capacity. Studies have shown that conventional lung function tests by spirometry have more precision in prognosis of patients with IPF, while extensive tests like gas exchange measurements at rest and exercise do not add additional information to make the prognostic or treatment evaluation more precise. .

Diagnosis

The diagnosis of IIPs is dynamic as it depends on multidisciplinary approach among different specialists. The histological patterns identified by the pathologists give better distinguishing pattern than imaging patterns identified by radiologists. That's why clinical-radiological-pathological diagnosis (CRP diagnosis) was

However the surgical biopsy is important for classification and confident CRP diagnosis, it is not always necessary to reach diagnosis, especially in the cases where there is a typical clinical-radiological picture of UIP/IPF. The diagnostic criteria for idiopathic pulmonary fibrosis adopted by AT/ERS.

AMERICAN THORACIC SOCIETY / EUROPEAN RESPIRATORY SOCIETY CRITERIA for diagnosing of IDIOPATHIC PULMONARY FIBROSIS in absence of surgical lung biopsy

" Major criteria:(must have all)" Exclusion of other known causes of ILD, such as certain drug toxicities, environmental exposures, and connective tissue diseases Restrictive pulmonary function studies (reduced VC, often with an increased FEV1/FVC ratio) and impaired gas exchange (increased P[A-a]O2, decreased PaO2 with rest or exercise or decreased DLCO) Bibasilar reticular abnormalities with minimal ground-glass opacities on HRCT scans Transbronchial lung biopsy/BAL showing no features to support an alternative diagnosis

" Minor criteria:" Age > 50 yr Insidious onset of unexplained dyspnea on exertion Duration illness > 3 mo Bibasilar, inspiratory crackles "

In the immunocompetent adult, the presence of all of the major diagnostic criteria + at least three of the four minor criteria increases the likelihood of a correct clinical diagnosis of IPF.