2018년 개정 지침에 따른 특발성 폐섬유증의 진단
New Diagnostic Guidelines for Idiopathic Pulmonary Fibrosis
2
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by worsening lung function and dyspnea. The prognosis of IPF patients is poor, as median survival is approximately 3 years. However, recently developed IPF-specific therapies have shown improved efficacies in terms of reducing lung function decline and mortality. Therefore, the early recognition and accurate diagnosis of IPF are crucial. In 2018, new guidelines for the diagnosis of IPF were published by the Fleischner Society and by the American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Society (ATS/ERS/JRS/ALAT). Both guidelines emphasize the need for a thorough history taking and physical examination to exclude an alternative diagnosis, such as exposure-related or connective tissue disease. The most informative initial examination is high-resolution computed tomography, the results of which can indicate the need for bronchoalveolar lavage or surgical lung biopsy, based on a multidisciplinary discussion of the findings and the patient’s clinical condition. A multidisciplinary discussion of the clinico-radiologic-pathologic findings is currently the gold standard in the diagnoisis of IPF and will allow the more effective and timely treatment of these patients.
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease characterized by worsening lung function and dyspnea. The prognosis of IPF patients is poor, as median survival is approximately 3 years. However, recently developed IPF-specific therapies have shown improved efficacies in terms of reducing lung function decline and mortality. Therefore, the early recognition and accurate diagnosis of IPF are crucial. In 2018, new guidelines for the diagnosis of IPF were published by the Fleischner Society and by the American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Society (ATS/ERS/JRS/ALAT). Both guidelines emphasize the need for a thorough history taking and physical examination to exclude an alternative diagnosis, such as exposure-related or connective tissue disease. The most informative initial examination is high-resolution computed tomography, the results of which can indicate the need for bronchoalveolar lavage or surgical lung biopsy, based on a multidisciplinary discussion of the findings and the patient’s clinical condition. A multidisciplinary discussion of the clinico-radiologic-pathologic findings is currently the gold standard in the diagnoisis of IPF and will allow the more effective and timely treatment of these patients.
참고문헌 (29)
- Lederer DJ, "Idiopathic pulmonary fibrosis", N Engl J Med, 378, pp.1811~1823 (2018)
- Barratt SL, "Idiopathic pulmonary fibrosis(IPF) : an overview", J Clin Med, 7, pp.E201~ (2018)
- Raghu G, "Diagnosis of idiopathic pulmonary fibrosis. An official ATS", ERS, ALAT clinical practice guideline, pp.Am J Respir Crit Care Med, 2018[DOI]
- American Thoracic Society, "Idiopathic pulmonary fibrosis:diagnosis and treatment: International consensus statement. American Thoracic Society (ATS), and the European Respiratory Society (ERS)", Am J Respir Crit Care Med, 161, pp.646~664 (2000)
- Raghu G, "An official ATS", ERS, ALAT statement : idiopathic pulmonary fibrosis : evidence-based guidelines for diagnosis and management, pp.Am J Respir Crit Care Med, 2011[DOI]
- Idiopathic Pulmonary Fibrosis Clinical Research Network, "Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis", N Engl J Med, 366, pp.1968~1977 (2012)
- King TE Jr, "A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis", N Engl J Med, 370, pp.2083~2092 (2014)
- Lynch DA, "Diagnostic criteria for idiopathic pulmonary fibrosis : a Fleischner Society White Paper", Lancet Respir Med, 6, pp.138~153 (2018)
- Richeldi L, "Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis", N Engl J Med, 370, pp.2071~2082 (2014)
- Mayo JR, "CT evaluation of diffuse infiltrative lung disease : dose considerations and optimal technique", J Thorac Imaging, 24, pp.252~259 (2009)
- Raghu G, "Diagnosis of idiopathic pulmonary fibrosis with high-resolution CT in patients with little or no radiological evidence of honeycombing : secondary analysis of a randomised, controlled trial", Lancet Respir Med, 2, pp.277~284 (2014)
- Chung JH, "CT scan findings of probable usual interstitial pneumonitis have a high predictive value for histologic usual interstitial pneumonitis", Chest, 147, pp.450~459 (2015)
- Kaarteenaho R, "The current position of surgical lung biopsy in the diagnosis of idiopathic pulmonary fibrosis", Respir Res, 14, pp.43~ (2013)
- Hutchinson JP, "In-hospital mortality after surgical lung biopsy for interstitial lung disease in the United States. 2000 to 2011", Am J Respir Crit Care Med, 193, pp.1161~1167 (2016)
- LoCicero J 3rd, "Does every patient with enigmatic lung disease deserve a lung biopsy? The continuing dilemma", Chest, 106, pp.706~708 (1994)
- Park JH, "Mortality and risk factors for surgical lung biopsy in patients with idiopathic interstitial pneumonia", Eur J Cardiothorac Surg, 31, pp.1115~1119 (2007)
- Raj R, "Surgical lung biopsy for interstitial lung diseases", Chest, 151, pp.1131~1140 (2017)
- Kayatta MO, "Surgical biopsy of suspected interstitial lung disease is superior to radiographic diagnosis", Ann Thorac Surg, 96, pp.399~401 (2013)
- Kreider ME, "Complications of video-assisted thoracoscopic lung biopsy in patients with interstitial lung disease", Ann Thorac Surg, 83, pp.1140~1144 (2007)
- Mouroux J, "Efficacy and safety of videothoracoscopic lung biopsy in the diagnosis of interstitial lung disease", Eur J Cardiothorac Surg, 11, pp.22~24 (1997)
- Ravaglia C, "Safety and diagnostic yield of transbronchial lung cryobiopsy in diffuse parenchymal lung diseases : a comparative study versus video-assisted thoracoscopic lung biopsy and a systematic review of the literature", Respiration, 91, pp.215~227 (2016)
- Tomassetti S, "Bronchoscopic lung cryobiopsy increases diagnostic confidence in the multidisciplinary diagnosis of idiopathic pulmonary fibrosis", Am J Respir Crit Care Med, 193, pp.745~752 (2016)
- Brownell R, "The use of pretest probability increases the value of high-resolution CT in diagnosing usual interstitial pneumonia", Thorax, 72, pp.424~429 (2017)
- Richeldi L, "Diagnosing idiopathic pulmonary fibrosis in 2018 : bridging recommendations made by experts serving different societies", Eur Respir J, 52, pp.1801485~ (2018)
- Wells AU, "IPF diagnosis : flexibility is a virtue", Lancet Respir Med, 6, pp.735~737 (2018)
- Meyer KC, "An official American Thoracic Society clinical practice guideline : the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease", Am J Respir Crit Care Med, 185, pp.1004~1014 (2012)
- Flaherty KR, "Idiopathic interstitial pneumonia : what is the effect of a multidisciplinary approach to diagnosis", Am J Respir Crit Care Med, 170, pp.904~910 (2004)
- Chaudhuri N, "A review of the multidisciplinary diagnosis of interstitial lung diseases : a retrospective analysis in a single UK specialist centre", J Clin Med, 5, pp.E66~ (2016)
- Jo HE, "Clinical impact of the interstitial lung disease multidisciplinary service", Respirology, 21, pp.1438~1444 (2016)