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Diagnostic Approaches for Idiopathic Pulmonary Fibrosis

Tuberculosis & Respiratory Diseases / Tuberculosis & Respiratory Diseases,
2024, v.87 no.1, pp.40-51
https://doi.org/10.4046/trd.2023.0087
Jin Woo Song, M.D., Ph.D. (Asan Medical Center, University of Ulsan College of Medicine, Seoul)
Jae Ha Lee, M.D., Ph.D. (Department of Internal Medicine, Inje University Haeundae Paik Hospital)
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Abstract

Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumoniawith a very poor prognosis. Accurate diagnosis of IPF is essential for good outcomesbut remains a major medical challenge due to variability in clinical presentationand the shortcomings of existing diagnostic tests. Medical history collection is the firstand most important step in the IPF diagnosis process; the clinical probability of IPF is high if the suspected patient is 60 years or older, male, and has a history of cigarettesmoking. Systemic assessment for connective tissue disease is essential in the initialevaluation of patients with suspected IPF to identify potential causes of interstitial lungdisease (ILD). Radiologic examination using high-resolution computed tomographyplays a pivotal role in the evaluation of patients with ILD, and prone and expiratory computedtomography images can be considered. If additional tests such as surgical lungbiopsy or transbronchial lung cryobiopsy are needed, transbronchial lung cryobiopsyshould be considered as an alternative to surgical lung biopsy in medical centers withexperience performing this procedure. Diagnosis through multidisciplinary discussion(MDD) is strongly recommended as MDD has become the cornerstone for diagnosisof IPF, and the scope of MDD has expanded to monitoring of disease progression andsuggestion of appropriate treatment options.

keywords
Interstitial Lung Disease, Idiopathic Pulmonary Fibrosis, Diagnosis

Tuberculosis & Respiratory Diseases