PT - JOURNAL ARTICLE AU - Paschalis Ntolios AU - Georgios Zacharis AU - Argyrios Tzouvelekis AU - Panagiotis Boglou AU - Evangelos Bouros AU - Konstantinos Kaltsas AU - Maria Karailidou AU - Theodoros Karampitsakos AU - Paschalis Steiropoulos AU - Marios Froudarakis AU - Demosthenes Bouros TI - Clinical findings at initial presentation of IPF patients at a university hospital referral center DP - 2014 Sep 01 TA - European Respiratory Journal PG - P3770 VI - 44 IP - Suppl 58 4099 - http://erj.ersjournals.com/content/44/Suppl_58/P3770.short 4100 - http://erj.ersjournals.com/content/44/Suppl_58/P3770.full SO - Eur Respir J2014 Sep 01; 44 AB - Introduction: IPF is a rare disease with dismal prognosis. International guidelines suggest early referring patients to specialized centers.Aim: To investigate whether physicians identify and treat IPF patients appropriately.Methods: 114 patients visited our outpatient clinic between January 2012 and December 2013 and were diagnosed with IPF (ATS/ERS/JRS/ALAT, 2011). Their demographics, smoking habit, comorbidities and clinical feature were recorded.Results: We studied 93 male and 21 female patients, 88 ex-smokers, 14 smokers and 12 non-smokers, of mean (SD) age 65.9 ± 10.52. Symptoms initiated even 3 years prior to presentation (range 3 months- 3 years) and included dyspnea (MRC 1: 24, MRC 2: 22, MRC III: 52, MRC IV: 16), non-productive cough (n=87, 76%), GER (n=96, 84%), fatigue (n=44, 38.5%) and depression (n=12, 10.5%). Comorbidities included arterial hypertension (n=52, 45.6%), cardiac failure (n=21, 18.4%), diabetes mellitus (n=19, 16.6%), osteoporosis (n=8, 7%) and emphysema (n=46, 40.5%). All had “Velcro” crackles (100%), 56 digital clubbing (49%) and 17 ankle edema (14.9%). Medication was in most cases inappropriate and even harmful; 35 patients were on corticosteroids (30.7%) and 12 on azathioprine (10.5%), while 67 patients (58.8%) were on inhaled bronchodilators/corticosteroids.Conclusions: Despite the publicity IPF has received during the last decade, it is still under-recognized by many physicians. Even when diagnosis is correct, treatment may be inappropriate. Physicians should be vigilant for “Velcro” crackles that could indicate lung fibrosis and refer patients to specialized centers.