RT Journal Article
SR Electronic
T1 Clinical findings at initial presentation of IPF patients at a university hospital referral center
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3770
VO 44
IS Suppl 58
A1 Paschalis Ntolios
A1 Georgios Zacharis
A1 Argyrios Tzouvelekis
A1 Panagiotis Boglou
A1 Evangelos Bouros
A1 Konstantinos Kaltsas
A1 Maria Karailidou
A1 Theodoros Karampitsakos
A1 Paschalis Steiropoulos
A1 Marios Froudarakis
A1 Demosthenes Bouros
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P3770.abstract
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.