New European Guidelines for the diagnosis of IPF
APF welcome the announcement on the 5th September of new guidelines for the diagnosis of IPF by the European Respiratory Society.
The main points:
- For all patients, a detailed history should be taken of both medication use and environmental exposures and serological testing should be performed to exclude connective tissue disease as a potential cause of the ILD.
- For patients with a HRCT pattern of probable UIP, indeterminate, or an alternative diagnosis, conditional recommendations were made for performing bronchoalveolar lavage (BAL) and surgical lung biopsy (SLB); due to lack of evidence, no recommendation was made for or against performing transbronchial lung biopsy (TBBx) or lung cryobiopsy.
- Conditional recommendation for MDD to aid in diagnosing IPF, particularly when the HRCT pattern has features of probable UIP pattern, indeterminate or alternative diagnosis.
- In contrast, for patients with newly detected ILD who have a HRCT pattern of UIP, strong recommendations were made against performing SLB, TBBx and lung cryobiopsy; a conditional recommendation was made against performing BAL.
- Strong recommendation against measurement of serum biomarkers for the sole purpose of distinguishing IPF from other ILDs.