Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline

Raghu, Ganesh; Rémy‐Jardin, Martine; Myers, Jeffrey L.; Richeldi, Luca; Ryerson, Christopher J.; Lederer, David J.; Behr, Jürgen; Cottin, Vincent; Danoff, Sonye K.; Morell, Ferrán; Flaherty, Kevin R.; Wells, Adrian; Martínez, Fernando J.; Azuma, Arata; Bice, Thomas; Bouros, Demosthenes; Brown, Kevin K.; Collard, Harold R.; Duggal, Abhijit; Galvin, Liam; Inoue, Yoshikazu; Jenkins, R Gisli; Johkoh, Takeshi; Kazerooni, Ella A.; Kitaichi, Masanori; Knight, Shandra L; Mansour, George; Nicholson, Andrew G.; Pipavath, Sudhakar; Buendía-Roldán, Ivette; Selman, Moisés; Travis, William D.; Walsh, Simon L.F.; Wilson, Kevin C.

doi:10.1164/rccm.201807-1255st

Cited by 3,126 publications

(3,452 citation statements)

References 149 publications

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“…There is a clear diagnostic impact of CryoTBB. SLB still remains an important step-up procedure, especially to allow the initiation of antifibrotic treatment in suspected idiopathic pulmonary fibrosis,2 but the number of SLBs may be substantially reduced in the future.…”

Section: Discussionmentioning

confidence: 99%

Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction

Hagmeyer

Theegarten

Wohlschläger

et al. 2019

Thorax

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Sixty-one subjects with fibrosing interstitial lung disease were prospectively analysed to determine the efficacy of transbronchial cryobiopsy (CryoTBB) and the effect of procedural modifications which were introduced after an interim analysis of the first 19 subjects. The modifications significantly reduced complication rates from 84% to 14% (p<0.001). 30-day-mortality was 2%. The algorithm with initial CryoTBB and surgical lung biopsy (SLB) as optional step-up procedure was feasible. CryoTBB led to a confident diagnosis in 46/61 subjects (75%). Only 21% out of all subjects were forwarded for SLB. As the modified CryoTBB reduced but not eliminated the risk of severe complications, tissue sampling should be limited to patients where confident diagnosis enables life prolonging therapy. Trial registration number: NCT01714518.

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Section: Discussionmentioning

confidence: 99%

Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction

Hagmeyer

Theegarten

Wohlschläger

et al. 2019

Thorax

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“…The injuries to alveolar epithelial cell and basement membrane lead to intra-alveolar proliferation of fibroblasts and abnormal healing. 7 Irrespective to the controversies in the usefulness of BALf cellular profile in the diagnosis of ILDs, BALf cells and chemokine/cytokine milieu were shown to reflect the proliferative and fibrotic changes in the local environment in the lung. Sarcoidosis is a systemic disorder characterized by noncaseating epithelioid cell granuloma formation in affected organs.…”

Section: Introductionmentioning

confidence: 99%

mRNA expression profile of bronchoalveolar lavage fluid cells from patients with idiopathic pulmonary fibrosis and sarcoidosis

Paplińska-Goryca

Goryca

Misiukiewicz-Stępień

et al. 2019

Eur J Clin Investigation

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“…Two radiologists (with 8 and 9 years’ experience in thoracic radiology) reviewed 80 CT scans taken when CIP first appeared to make final decisions with consensus. CIP was categorized into four patterns: UIP, probable UIP, indeterminate for UIP, and non‐UIP in accordance with the American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Association Statement …”

Section: Methodsmentioning

confidence: 99%

Significance of baseline computed tomography assessment for predicting the pulmonary fibrosis during the course of chemotherapy‐induced pneumonitis

Han

Lee

et al. 2019

Asia-Pac J Clncl Oncology

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Background The purpose of our study is to evaluate risk factors for the development of pulmonary fibrosis in the baseline computed tomography (CT) during the course of chemotherapy‐induced pneumonitis (CIP). Methods We retrospectively identified 80 cases of CIP by clinical, radiological, and pathological findings. When fibrosis developed during the follow‐up, the extent of pulmonary fibrosis was evaluated at final follow‐up CT in terms of a 5% volumetric score for six zones. Univariate and multivariate analyses were performed to identify the clinical and radiological risk factors for the development of fibrosis and severe fibrosis over 11% in extent. Results Fibrosis occurred in 26 of the 80 total patients (32.5%) during a mean 5.6 months of follow up. Risk factors for developing fibrosis were revealed as preexisting interstitial lung disease (ILD) and moderate to severe emphysema in multivariate analysis (OR = 10.12, 95% CI = 2.35‐43.66, and OR = 12.85, 95% CI = 2.81‐58.82, respectively). Risk factors for developing severe fibrosis over 11% in extent were revealed as a moderate to severe emphysema (OR = 5.78, 95% CI = 1.07‐31.26) in multivariate analysis. Conclusions Moderate to severe emphysema as well as preexisting ILD visible on baseline CT are risk factors for developing pulmonary fibrosis in the course of CIP. Thin‐section CT may be helpful to predict the risk of pulmonary fibrosis before administering chemotherapy.

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Diagnosis of Idiopathic Pulmonary Fibrosis. An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline

Abstract: The guideline panel provided recommendations related to the diagnosis of IPF.

Cited by 3,126 publications

References 149 publications

Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction

Transbronchial cryobiopsy in fibrosing interstitial lung disease: modifications of the procedure lead to risk reduction

mRNA expression profile of bronchoalveolar lavage fluid cells from patients with idiopathic pulmonary fibrosis and sarcoidosis

Significance of baseline computed tomography assessment for predicting the pulmonary fibrosis during the course of chemotherapy‐induced pneumonitis

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