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. 2010 Apr 15;181(8):832-7.
doi: 10.1164/rccm.200906-0959OC. Epub 2010 Jan 7.

Clinical predictors of a diagnosis of idiopathic pulmonary fibrosis

Charlene D Fell  1 , Fernando J Martinez, Lyrica X Liu, Susan Murray, Meilan K Han, Ella A Kazerooni, Barry H Gross, Jeffrey Myers, William D Travis, Thomas V Colby, Galen B Toews, Kevin R Flaherty
Affiliations

Clinical predictors of a diagnosis of idiopathic pulmonary fibrosis

Charlene D Fell et al. Am J Respir Crit Care Med. .

Abstract

Rationale: Idiopathic pulmonary fibrosis (IPF) and other idiopathic interstitial pneumonias (IIPs) have similar clinical and radiographic features, but their histopathology, response to therapy, and natural history differ. A surgical lung biopsy is often required to distinguish between these entities.

Objectives: We sought to determine if clinical variables could predict a histopathologic diagnosis of IPF in patients without honeycomb change on high-resolution computed tomography (HRCT).

Methods: Data from 97 patients with biopsy-proven IPF and 38 patients with other IIPs were examined. Logistic regression models were built to identify the clinical variables that predict histopathologic diagnosis of IPF.

Measurements and main results: Increasing age and average total HRCT interstitial score on HRCT scan of the chest may predict a biopsy confirmation of IPF. Sex, pulmonary function, presence of desaturation, or distance walked during a 6-minute walk test did not help discriminate pulmonary fibrosis from other IIPs.

Conclusions: Clinical data may be used to predict a diagnosis of IPF over other IIPs. Validation of these data with a prospective study is needed.

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Figures

Figure 1.
Figure 1.
CONSORT diagram illustrating the selection of patients included in the data analysis. CTD-ILD = connective tissue disease–related interstitial lung disease; HRCT = high-resolution computed tomography; IIP = idiopathic interstitial pneumonia; IPF = idiopathic pulmonary fibrosis; PFT = pulmonary function tests; 6MWT = 6-minute walk test.
Figure 2.
Figure 2.
Examples of varied high-resolution computed tomography (HRCT) alveolar and HRCT interstitial scores. Each panel is from a different patient. The scores for each panel are for the image that is displayed. Scores are represented as alveolar/interstitial. LLL = left lower lobe; LUL = left upper lobe; RLL = right lower lobe; RUL = right upper lobe.
Figure 3.
Figure 3.
Histogram illustrating the frequency of the probability of idiopathic pulmonary fibrosis (IPF) scores for patients with a biopsy-proven diagnosis of IPF (n = 97) and non-IPF (n = 38). Solid columns, IPF; striped columns, non-IPF.
See this image and copyright information in PMC

Comment in

  • The age of idiopathic pulmonary fibrosis.
    Collard HR. Collard HR. Am J Respir Crit Care Med. 2010 Apr 15;181(8):771-2. doi: 10.1164/rccm.201001-0049ED. Am J Respir Crit Care Med. 2010. PMID: 20382799 No abstract available.

References

    1. American Thoracic Society/European Respiratory Society. International multidisciplinary consensus classification of the idiopathic interstitial pneumonias. Am J Respir Crit Care Med 2002;165:277–304. - PubMed
    1. Martinez FJ. Idiopathic interstitial pneumonias: usual interstitial pneumonia versus nonspecific interstitial pneumonia. Proc Am Thorac Soc 2006;3:81–95. - PubMed
    1. Flaherty K, Toews G, Travis W, Colby T, Kazerooni E, Gross B, Jain A, Strawderman R III, Paine R III, Flint A, et al. Clinical significance of histological classification of idiopathic interstitial pneumonia. Eur Respir J 2002;19:275–283. - PubMed
    1. Jegal Y, Kim DS, Shim TS, Lim CM, Do Lee S, Koh Y, Kim WS, Kim WD, Lee JS, Travis WD, et al. Physiology is a stronger predictor of survival than pathology in fibrotic interstitial pneumonia. Am J Respir Crit Care Med 2005;171:639–644. - PubMed
    1. Bjoraker J, Ryu J, Edwin M, Myers J, Tazelaar H, Schoreder D, Offord K. Prognostic significance of histopathologic subsets in idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998;157:199–203. - PubMed

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