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Pulmonary Fibrosis

Avignat S. Patel, MD Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Pulmonary fibrosis (PF) is an interstitial lung disease (ILDs), a family of >200 different lung diseases, characterized by inflammation, cellular proliferation, and/or fibrosis wi...

DIAGNOSIS

HISTORY

  • Gradual onset

  • Exertional breathlessness and nonproductive cough

  • Constitutional symptoms (weight loss, fever, fatigue, myalgias, arthralgias) are uncommon.

  • History of exposure (see "Risk ...

TREATMENT

GENERAL MEASURES

  • Smoking cessation

  • Vaccinations: pneumococcus, influenza, SARS-CoV2

  • Pulmonary rehabilitation

  • Referral to a transplant center

  • Supplemental oxygen:

    • Clinical practice guidelines stron...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Pulmonary clinic and, if possible, at an ILD clinic.

  • Monitoring with serial HRCT, PFT along with 6MWD

  • If on antifibrotic medications, monitor LFTs.

PROGNOSIS

IPF carr...

REFERENCES

1
Raghu  G, Remy-Jardin  M, Myers  JL, et al; for American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, Latin American Thoracic Societ...

CODES

ICD10

  • J84.10 Pulmonary fibrosis, unspecified

  • J84.112 Idiopathic pulmonary fibrosis

SNOMED

  • 51615001 Fibrosis of lung (disorder)

  • 700250006 Idiopathic pulmonary fibrosis (disorder)

  • 266368002 Post-inflamm...

CLINICAL PEARLS

  • IPF is the most common idiopathic ILD and frequently misdiagnosed or has delayed diagnosis.

  • High-resolution CT scan is the cornerstone for diagnosis.

  • Two anti-fibrotic drugs are the only...

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