Lung Biology in Health and Disease Volume 185 Idiopathic by Joseph P. Lynch III

By Joseph P. Lynch III

A dialogue of the epidemiology, scientific positive factors, and differential diagnoses of idiopathic pulmonary fibrosis (IPF). Key issues comprise the function of polymorphonuclear leukocytes within the pathogenesis of pulmonary fibrosis, and present remedies, together with clinical remedy and lung transplantation.

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Lung Biology in Health and Disease Volume 185 Idiopathic Pulmonary Fibrosis

A dialogue of the epidemiology, scientific good points, and differential diagnoses of idiopathic pulmonary fibrosis (IPF). Key themes contain the function of polymorphonuclear leukocytes within the pathogenesis of pulmonary fibrosis, and present treatment plans, together with clinical treatment and lung transplantation.

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Medications Interstitial lung disease is a recognized adverse effect of a number of drugs, particularly amiodarone, nitrofurantoin, and cytotoxic agents. However, interstitial lung disease has also been reported as being a rare complication of some much more commonly used drugs, including antidepressants (42–45), antibiotics (46–49), beta-blockers (50–53), anticonvulsants (54,55), and nonsteroidal anti-inflammatory drugs (NSAIDs) (56–60). These observations 14 Coultas and Hubbard suggest that some cases of IPF may be a rare complication of commonly used drugs.

Interferon Gamma-1b One trial of interferon gamma-1b has been completed and, this included 18 nonsmoking patients with progressive IPF and who had not been treated with corticosteroids (109). 5 mg a day. An improvement in total lung capacity (TLC) was found in all patients who received interferon gamma-1b, which was in marked contrast to the patients who received oral corticosteroids alone, all of whom had a decline in TLC. Other Treatments Patients with IPF are often hypoxemic, particularly after exertion, and supplemental oxygen has been shown to ameliorate symptoms of breathlessness (110), and this should be considered as palliative treatment.

Using their clinical diagnosis, regardless of diagnostic certainty, their accuracy for diagnosing IPF was 68% with a sensitivity of 85%, specificity of 43%, and positive predictive value of 69%. 5% when their clinical diagnosis was IPF, but they were not certain. Raghu et al. (14) also examined diagnostic test characteristics for the clinical evaluation of IPF using the surgical lung biopsy as the gold standard. However, since only one pulmonary pathologist interpreted the biopsy specimens, the reliability of the surgical biopsy could not be evaluated.

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