What is it about?
IPF patients often present with cough and/or shortness of breath. These symptoms are commonly reported by patients who have more commonly encountered medical conditions such as chronic sinusitis and esophageal reflux in the case of cough, or cardiac disease and other lung disease in the case of shortness of breath. In this secondary care based cohort of 96 patients with IPF we could identify 4 groups of IPF patients according to pre-existing other medical conditions, evident 5 years before IPF diagnosis. The great majority of patients had abnormal breathing sounds on lung auscultation, known as velcro sounds. One group of patients (cluster) had prevalent coronary heart disease. Another cluster had prevalent emphysema (an obstructive lung disease related to smoking). The third cluster had no prevalent background illness. The fourth group consisted of women with prevalent thyroid gland dysfunction.
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Why is it important?
Initial presentation of patients with IPF may be subtle as symptoms often suggest other more commonly encountered conditions that may cause cough or breathlessness. Pre-existing disease processes, such as heart failure or pulmonary emphysema, may make the clinical picture of IPF at presentation blurry, even for experienced clinicians. Therefore, an increased awareness of the possibility of IPF in certain clinical constellations is supported by our findings.
Perspectives
Our findings add up to recently published studies of cluster analysis of patients with already established diagnosis of IPF or Interstitial Lung Disease, with somewhat overlapping findings. Interestingly, additional studies demonstrate an increased health resources utilization, in the years just before the diagnosis of IPF. Regardless to the profile of the individual patient being evaluated, this study shows that detection of abnormal breathing sounds on lung examination, known as velcro sounds, should invoke further testing, which usually starts with high-resolution CT of the lung.
Dr Samir Nusair
Hebrew University of Jerusalem
Read the Original
This page is a summary of: Cluster analysis based clinical profiling of Idiopathic Pulmonary Fibrosis patients according to comorbidities evident prior to diagnosis: a single-center observational study, European Journal of Internal Medicine, June 2020, Elsevier,
DOI: 10.1016/j.ejim.2020.05.023.
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