Bronchoalveolar Lavage as a Possible Cause of Acute Exacerbation in Idiopathic Pulmonary Fibrosis Patients.

An Official ATS/ERS/JRS/ALAT Statement: Idiopathic Pulmonary Fibrosis: Evidence-based Guidelines for Diagnosis and Management

“…Worsened cough, fever, and/or increased sputum have been observed (148,149,153). While there are no known risk factors for acute exacerbation of IPF, there have been reports of acute respiratory decompensation after thoracic surgery (161-165) and bronchoalveolar lavage (149,166). It is unclear whether or not these events represent true acute exacerbations or complications of the respective procedures.…”

Acute exacerbation of idiopathic pulmonary fibrosis: frequency and clinical features

“…have been several reports of AE after SLBx [6,7], lung resection [8,9], or BAL [10][11][12]. Furthermore, UTZ et al [29] reported that the short-term mortality rate (16.7%) after SLBx was higher in patients with IPF/UIP, compared with the mortality rate of 1.7% in 771 unselected patients undergoing SLBx at the same institution [30].…”

“…Although the clinical course is usually chronic and slowly progressive [1][2][3][4][5], some patients experience rapid deterioration during the course of their illness. Most reports on this phenomenon of acute exacerbation (AE) of IPF have appeared in the Japanese medical literature [6][7][8][9][10][11][12][13][14]. In the English medical literature, COLBY [15] and KITAICHI [16] first reported the pathological findings of AE as diffuse alveolar damage (DAD) superimposed on UIP.…”

Evaluation of patients with fibrotic interstitial lung disease: A Canadian Thoracic Society position statement

“…[36][37][38][39][40] Recent guidelines recommend against BAL in the evaluation of most IPF patients but acknowledge that it may be appropriate in a minority. 2 Given the absence of additional supportive data, the primary role of BAL in fibrotic ILD is to exclude infection in patients presenting with suggestive clinical and radiological features, especially if immunosuppressive therapy is being considered.…”