Acute exacerbation of idiopathic pulmonary fibrosis: an algorithmic approach to diagnosis and management

[Diagnosis and Treatment of Pulmonary Embolism and Pulmonary Hypertension in Patients With Interstitial Lung Disease]

Pulmonary embolism (PE) and pulmonary hypertension (PH) are common comorbidities that worsen the prognosis of patients diagnosed with interstitial lung disease (ILD). Despite advances in the diagnosis and treatment of these entities, their impact on the management and progression of ILD is not sufficiently studied. This article includes a review and update of the diagnosis and treatment of PE and PH in patients with underlying ILD.

Idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is defined as a chronic progressive fibrosing interstitial pneumonia of unknown etiology. There are intrinsic and extrinsic risk factors that could favor the development of the disease in individuals with a genetic predisposition. The diagnosis is made by characteristic radiological and/or histological findings on high-resolution computed tomography and lung biopsy, respectively, in the absence of a specific identifiable cause. The median survival of the disease for patients without treatment is 3-5years from the onset of symptoms, although its natural history is variable and unpredictable. Currently, there are two antifibrotic drugs that reduce disease progression. The multidisciplinary approach will consider the nutritional and emotional status, physical conditioning, and treatment of comorbidities, as well as lung transplantation and palliative care in advanced stages. The following article reviews the fundamental aspects for the diagnosis and treatment of idiopathic pulmonary fibrosis.