Computed Tomography Findings in Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Akira, Masanori; Kozuka, Takenori; Yamamoto, Satoru; Sakatani, Mitsunori

doi:10.1164/rccm.200709-1365oc

Cited by 221 publications

(201 citation statements)

References 19 publications

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“…Clinical features are similar in patients with other causes of acute respiratory worsening [24]. HRCT shows a background of fibrotic interstitial lung disease, with superimposed bilateral ground glass changes, with or without consolidation [58]. Transbronchial and surgical lung biopsies are generally avoided since they infrequently alter management and have a high risk of complications.…”

Section: Clinical Features and Diagnostic Evaluationmentioning

confidence: 93%

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

et al. 2015

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The goal of this review is to summarise the clinical features, management, and prognosis of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). AE-IPF has previously been defined based on clinical and radiological features that include the subacute onset of dyspnoea, bilateral ground glass changes on chest high-resolution computed tomography, and the absence of an identifiable aetiology. The annual incidence of AE-IPF is typically reported at 5-15%, but is less common in mild disease. Features of diffuse alveolar damage are present when a biopsy is performed. Idiopathic pulmonary fibrosis (IPF) patients with acute respiratory worsening are often initially treated with high dose corticosteroids and antimicrobials; however, there are no clear data to support these therapies, and the short-term mortality of AE-IPF is ∼50%. Recent studies have shown that the features and prognosis of AE-IPF are similar to other causes of acute respiratory worsening, including infection, aspiration, air pollution and mechanical injury to the alveolar epithelium. Based on this emerging evidence, we propose a novel approach to the classification of acute respiratory worsening events in patients with IPF that focuses on clinical and radiological findings consistent with an underlying pathobiology of diffuse alveolar damage. @ERSpublications A review summarising the features, management, and prognosis of acute exacerbations of idiopathic pulmonary fibrosis

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Section: Clinical Features and Diagnostic Evaluationmentioning

confidence: 93%

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

et al. 2015

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“…17). In the study of Akira and colleagues, 42 there were significant differences in survival based on this distribution, as follows: diffuse (0% at 100 days), multifocal (50% at 500 days), and peripheral (75% at 500 days). Fig.…”

Section: Acute Exacerbation Of Interstitial Lung Diseasementioning

confidence: 93%

Imaging of Acute Lung Injury

Elicker¹,

Jones

Naeger

et al. 2016

Radiologic Clinics of North America

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“…First, phase III trial of pirfenidone showed there was a relative reduction of 47.9% in the proportion of patients who had an absolute decline of 10 percentage points or more in the percentage of the predicted FVC or who died over 52 weeks (P<0.001) (65). In addition, pirfenidone had significant effect on reduction for death from any cause (P=0.01) and from IPF (P=0.006).…”

Section: Clinical Trialsmentioning

confidence: 99%