An earlier and more confident diagnosis of idiopathic pulmonary fibrosis

A diagnosis of idiopathic pulmonary fibrosis (IPF) has serious implications for the affected individuals, who have a 50% likelihood of dying within 2−3 yrs, an outcome which is worse than many cancers. A swift and accurate diagnosis is imperative, especially as commencing treatment at a relatively e...

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Main Author: R.M. du Bois
Format: Article
Language:English
Published: European Respiratory Society 2012-06-01
Series:European Respiratory Review
Subjects:
Online Access:http://err.ersjournals.com/content/21/124/141.full.pdf+html
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author R.M. du Bois
author_facet R.M. du Bois
author_sort R.M. du Bois
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description A diagnosis of idiopathic pulmonary fibrosis (IPF) has serious implications for the affected individuals, who have a 50% likelihood of dying within 2−3 yrs, an outcome which is worse than many cancers. A swift and accurate diagnosis is imperative, especially as commencing treatment at a relatively early disease stage may have the greatest impact on reducing disease progression. The 2011, IPF guidelines provide updated and simplified IPF diagnostic criteria that may facilitate making a more confident diagnosis. The key investigational tool is high-resolution computed tomography (HRCT). In the presence of the four classical features, that together accurately identify a usual interstitial pneumonia (UIP) pattern, a definitive diagnosis of IPF can be made. When HRCT honeycombing is absent, even in the presence of all other features including traction bronchiectasis, the guidelines provide no designation for this constellation of features that many clinicians and radiologists would regard as consistent with UIP. The diagnostic algorithm suggested by the 2011 guidelines emphasises the importance of multidisciplinary discussion between clinicians, radiologists and pathologists to improve diagnostic confidence. The course of disease in IPF is unpredictable, but the importance of an early diagnosis is clear, as individuals with less severe lung function abnormalities have a better prognosis.
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spelling doaj.art-7db562dae96d42b3a772b155613bc1102022-12-22T01:43:01ZengEuropean Respiratory SocietyEuropean Respiratory Review0905-91801600-06172012-06-0121124141146An earlier and more confident diagnosis of idiopathic pulmonary fibrosisR.M. du BoisA diagnosis of idiopathic pulmonary fibrosis (IPF) has serious implications for the affected individuals, who have a 50% likelihood of dying within 2−3 yrs, an outcome which is worse than many cancers. A swift and accurate diagnosis is imperative, especially as commencing treatment at a relatively early disease stage may have the greatest impact on reducing disease progression. The 2011, IPF guidelines provide updated and simplified IPF diagnostic criteria that may facilitate making a more confident diagnosis. The key investigational tool is high-resolution computed tomography (HRCT). In the presence of the four classical features, that together accurately identify a usual interstitial pneumonia (UIP) pattern, a definitive diagnosis of IPF can be made. When HRCT honeycombing is absent, even in the presence of all other features including traction bronchiectasis, the guidelines provide no designation for this constellation of features that many clinicians and radiologists would regard as consistent with UIP. The diagnostic algorithm suggested by the 2011 guidelines emphasises the importance of multidisciplinary discussion between clinicians, radiologists and pathologists to improve diagnostic confidence. The course of disease in IPF is unpredictable, but the importance of an early diagnosis is clear, as individuals with less severe lung function abnormalities have a better prognosis.http://err.ersjournals.com/content/21/124/141.full.pdf+htmlDiagnostic criteriaearly diagnosishigh-resolution computed tomographyidiopathic pulmonary fibrosisusual interstitial pneumonia
spellingShingle R.M. du Bois
An earlier and more confident diagnosis of idiopathic pulmonary fibrosis
European Respiratory Review
Diagnostic criteria
early diagnosis
high-resolution computed tomography
idiopathic pulmonary fibrosis
usual interstitial pneumonia
title An earlier and more confident diagnosis of idiopathic pulmonary fibrosis
title_full An earlier and more confident diagnosis of idiopathic pulmonary fibrosis
title_fullStr An earlier and more confident diagnosis of idiopathic pulmonary fibrosis
title_full_unstemmed An earlier and more confident diagnosis of idiopathic pulmonary fibrosis
title_short An earlier and more confident diagnosis of idiopathic pulmonary fibrosis
title_sort earlier and more confident diagnosis of idiopathic pulmonary fibrosis
topic Diagnostic criteria
early diagnosis
high-resolution computed tomography
idiopathic pulmonary fibrosis
usual interstitial pneumonia
url http://err.ersjournals.com/content/21/124/141.full.pdf+html
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