Tejaswini Kulkarni, MD, MPH: Defining & Diagnosing Acute Exacerbations of IPF

Defining and diagnosing idiopathic pulmonary fibrosis (IPF) is of the upmost importance due to the irreversible and progressive decline in lung function caused by the rare pulmonary disease. With recent guideline updates though, disease diagnosis and definition can now be further assisted.

At the 2018 CHEST Annual Meeting in San Antonio, TX, Tejaswini Kulkarni, MD, MPH, assistant professor, University of Alabama at Birmingham, sat down with MD Magazine® and reviewed how acute exacerbations of IPF are defined and diagnosed.

MD Mag: How are acute exacerbations of IPF defined and diagnosed?

Currently, an acute exacerbation of IPF is defined as acute, clinically significant respiratory deterioration that is characterized by evidence of new widespread alveolar abnormalities.

The diagnostic criteria are previous or a current diagnosis of IPF, acute worsening or the development of dyspnea within the past 1-month, computed tomography (CT) scan findings of new bilateral ground-glass opacities, and/or consolidations that are superimposed on a background pattern of usual interstitial pneumonia, and then final the deterioration that is not fully explained by cardiac failure or fluid overload.

These were the diagnostic criteria that were defined in a 2016 paper that talked about acute exacerbations of IPF.

The only difference we saw from 2007, and a very importance difference, was that these new guidelines do not require a clinician to absolutely exclude other causes like infection or other triggers like reflux of aspiration to call it an IPF exacerbation.

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