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Differential Diagnosis of IPF

What Should We Particularly Keep in Mind in the Differential Diagnosis?

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Idiopathic Pulmonary Fibrosis

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Abstract

The idiopathic pulmonary fibrosis (IPF) guidelines were announced in the 2011 ATS/ERS/JRA/ALAT statement, and 6 items were listed as Summary Conclusions. Diagnosis is described in item 2, and both exhibiting a UIP pattern on high-resolution computed tomography (HRCT) scans, and that finding being consistent with the SLB findings are said to be necessary. The factors that are suspected of being associated with IPF and are important to the differential diagnosis have also been sorted out, and we consider them to mainly consist of three categories of factors and miscellaneous other factors. The first category is chronic hypersensitivity pneumonitis (CHP)/Feather duvet lung (FDL) caused by environmental factors. The second category is autoimmune-featured interstitial lung disease (AIF-ILD) in which lung lesions are observed first. The third category consists of PF that develops after a certain period of time has passed in patients treated with molecularly targeted drugs, anti-arrhythmia drugs, etc. The rest consist of PF caused by persistent infection. Because the time that has passed (sometimes as much as several years) after the corresponding episode is long, and the HRCT findings and SLB findings resemble the findings in a usual interstitial pneumonia (UIP), differentiation is difficult even when a diagnosis of PF has been made. A wide variety of possibilities are suspected when PF is encountered, and it is necessary to confirm the detail of past medical history and base on it to perform special tests (e.g., lymphocyte stimulation tests, antibody tests, virus DNA tests) in addition.

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Authors and Affiliations

  1. Department of Respiratory Medicine and Infection Control, Ibaraki Medical Center, Tokyo Medical University, 3-20-1 Chuo Amin, Inashiki, Ibaraki, 300-0395, Japan

    Hidehiro Watanabe

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Correspondence to Hidehiro Watanabe .

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  1. Department of Respiratory Medicine, Tokyo Medical University, Ibaraki Medical Center , Ibaraki, Japan

    Hiroyuki Nakamura

  2. Department of Respiratory Medicine , Tokyo Medical University, Ibaraki Medical Center, Ibaraki, Japan

    Kazutetsu Aoshiba

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Watanabe, H. (2016). Differential Diagnosis of IPF. In: Nakamura, H., Aoshiba, K. (eds) Idiopathic Pulmonary Fibrosis. Springer, Tokyo. https://doi.org/10.1007/978-4-431-55582-7_8

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  • DOI: https://doi.org/10.1007/978-4-431-55582-7_8

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