Diagnostic Criteria For Idiopathic Pulmonary Fibrosis Research Articles

Investigation of viral infection in idiopathic pulmonary fibrosis among Iranian patients in Tehran.

Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease, which can be lethal with chronic complications. Viral infections may be associated with IPF and other fibrotic lung diseases. In the present study, we investigate for the first time in Iran the related viral etiology of IPF in order to detect three respiratory viruses; human adenovirus, enterovirus and bocavirus. In this cross-sectional study which was supported by Iran University of Medical Sciences, Tehran, Iran. The diagnostic criteria for IPF were based on internationally accepted clinical and imaging criteria in accordance with the 2011 IPF guidelines. 30 nasopharyngeal (NP) swabs or broncho-alveolar lavage (BAL) samples were obtained from the lung of IPF patients that were diagnosed by a sophisticated practitioner from April 2015 to February 2016. Real-time (RT) polymerase chain reaction (PCR) method was performed to detect the three viruses. Fluorescence dye of a labeled probe recorded the results in order to create positive and negative controls. SPSS version 20 software was used to calculate basic descriptive and frequency features. Of 30 specimens, 13 (43.4%) were male and 17 (56.6%) were female with the total mean age±standard deviation 68.2±12.0. RT-PCR assay results illustrated there was no infection of human adenovirus, enterovirus, and bocavirus detected in these samples. Significant results between IPF incidence and variables were not significant (p>0.05). The causes of IPF in Iranian patients need more research although, based on the results of this study, there was no association between human adenovirus, enterovirus, bocavirus, and IPF.

Diagnostic disparity of previous and revised American Thoracic Society guidelines for idiopathic pulmonary fibrosis.

A revised guideline for the diagnosis of idiopathic pulmonary fibrosis (IPF) was formulated by the American Thoracic Society (ATS) in 2011 to improve disease diagnosis and provide a simplified algorithm for clinicians. The impact of these revisions on patient classification, however, remain unclear. To examine the concordance between diagnostic guidelines to understand how revisions impact patient classification. A cohort of 54 patients with either suspected IPF or a working diagnosis of IPF was evaluated in a retrospective chart review, in which patient data were examined according to previous and revised ATS guidelines. Patient characteristics influencing the fulfillment of diagnostic criteria were compared using one-way ANOVA and χ(2) tests. Revised and previous guideline criteria for IPF were met in 78% and 83% of patients, respectively. Revised guidelines modified a classification based on previous guidelines in 28% of cases. Fifteen percent of patients meeting previous ATS guidelines failed to meet revised criteria due to a lack of honeycombing on high-resolution computed tomography and the absence of a surgical lung biopsy. Patients failing to meet previous and revised diagnostic criteria for IPF were younger. The revised guidelines for the diagnosis of IPF classify a substantial proportion of patients differently than the previous guidelines.

Lung surgery in interstitial lung disease-a safe and useful procedure?

The group of interstitial lung diseases (ILD) includes a wide spectrum of disorders with variable clinical presentation, treatment response and prognosis. Idiopathic pulmonary fibrosis (IPF) is by far the most dismal disease in this group, with a median survival time of just 3-4 years (1). The diagnostic criteria for IPF are based on exclusion of any other cause for ILD by thorough clinical history, and a typical radiographic image revealing a so-called usual interstitial pneumonia (UIP) pattern in a high resolution computed tomography (HRCT) (2).