Speaking of the “Devil”: Diagnostic Errors in Interstitial Lung Diseases

Arcana, Raluca Ioana; Crișan-Dabija, Radu Adrian; Caba, Bogdan; Zamfir, Alexandra-Simona; Cernomaz, Tudor Andrei; Zabara-Antal, Andreea; Zabara, Mihai Lucian; Arcana, Ștefăniță; Marcu, Dragoș Traian; Trofor, Antigona

doi:10.3390/jpm13111589

JPM

2023

DOI: 10.3390/jpm13111589

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Speaking of the “Devil”: Diagnostic Errors in Interstitial Lung Diseases

Raluca Ioana Arcana,

Radu Adrian Crișan-Dabija,

Bogdan Caba

et al.

Abstract: Interstitial lung diseases are respiratory diseases, which affect the normal lung parenchyma and can lead to significant pulmonary fibrosis, chronic respiratory failure, pulmonary hypertension, and ultimately death. Reuniting more than 200 entities, interstitial lung diseases pose a significant challenge to the clinician, as they represent rare diseases with vague and insidious respiratory symptoms. As such, there are many diagnostic errors that can appear along the journey of the patient with ILD, which leads… Show more

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2024

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Cited by 2 publications

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Misdiagnosis of interstitial lung diseases according to the register of Irkutsk

Trofimenko,

Nashatyreva,

Chernyak

2024

Pulʹmonologiâ (Mosk.)

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The course of interstitial lung diseases (ILD) is characterized by high variability. The extent and heterogeneity of ILDs inevitably leads to diagnostic difficulties. The aim of the study was to analyze misdiagnosis of ILD in patients included in the Irkutsk register. Methods. 270 patients aged 18 – 88 years with various ILDs were followed in the register. The diagnosis of ILD was based on clinical, laboratory, functional, radiological (high-resolution computed tomography (HRCT)) and, if necessary, histological findings. All diagnoses were discussed by a multidisciplinary team. Results. The time from the first signs of interstitial lesions to the diagnosis of ILD varied from several months to several years (0 – 22 years), with a median of 12 (3; 36) months. Only half of the 155 (57.4%) patients with ILD were diagnosed within one year from the first symptoms. Misdiagnoses in patients with respiratory symptoms and/or HRCT changes prior to ILD verification included various forms of pneumonia (recurrent, prolonged course) in 24.4%, pneumosclerosis in 12.6%, obstructive lung disease in 12.6%, and tuberculosis in 10.7%. The main causes of misdiagnosis were underestimation or misinterpretation of clinical, radiological and functional data. Late diagnosis is one of the factors determining progressive pulmonary fibrosis: time to diagnosis ≥ 12 months – odds ratio (OR) of 4.1 (95% confidence interval (CI) 2.4 – 7.1); p < 0.001. Conclusion. To overcome the misdiagnosis of ILD, it is necessary to inform and alert general practitioners, to maximize the effectiveness of the examination of a patient with suspected ILD, and to immediately refer such a patient to a competent specialist to diagnose ILD and verify the diagnosis with a multidisciplinary team.

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Misdiagnosis of interstitial lung diseases according to the register of Irkutsk

Trofimenko,

Nashatyreva,

Chernyak

2024

Pulʹmonologiâ (Mosk.)

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Navigating Drug-Induced Lung Disease (DILD): A Comprehensive Review on Management and Prevention Strategies

Annareddy,

Ghewade,

Jadhav

et al. 2024

Cureus

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Drug-induced lung disease (DILD) is a significant and often overlooked adverse effect of pharmacological treatments, encompassing a range of pulmonary disorders triggered by medications. This review provides a comprehensive overview of DILD, focusing on its definition, pathophysiology, and clinical implications. We explore the epidemiology of DILD, highlighting the prevalence of various drugs associated with pulmonary toxicity and the factors influencing susceptibility. The review details the clinical presentation of DILD, including common symptoms and diagnostic challenges, and outlines diagnostic modalities such as imaging, pulmonary function tests, and invasive procedures. Management strategies are discussed, emphasizing the importance of timely drug discontinuation, supportive care, and the role of corticosteroids and novel therapies. Preventive measures, including pre-treatment evaluations and ongoing monitoring, are also addressed. The review concludes by examining future research directions and emerging therapies, aiming to enhance the understanding and management of DILD. This review is intended to aid healthcare professionals in recognizing, managing, and preventing drug-induced lung diseases, ultimately improving patient outcomes and safety.

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Speaking of the “Devil”: Diagnostic Errors in Interstitial Lung Diseases

Cited by 2 publications

References 41 publications

Misdiagnosis of interstitial lung diseases according to the register of Irkutsk

Misdiagnosis of interstitial lung diseases according to the register of Irkutsk

Navigating Drug-Induced Lung Disease (DILD): A Comprehensive Review on Management and Prevention Strategies

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