[Clinical presentation and medical management in patients with idiopathic pulmonary fibrosis before diagnosis].

UNLABELLED

The aim of the study was to find factors that may influence diagnostic process of idiopathic pulmonary fibrosis (IPF). Clinical presentation and medical management in the period before the diagnosis of IPF were assessed in 57 patients. There were 25 females and 32 males in the study group; mean age was 61.4 +/- 10.9 years. Mean duration of symptoms in the whole group was 18.4 +/- 16.0 months. The most common symptoms were dyspnea on exertion (96.5% of cases) and cough (84.2% of cases). 56 out of 57 patients (98.2% of cases) had crackles on auscultation of the lungs. In one third of the patients clubbing of the fingers was found. Mean FVC% of predicted was 77.2 +/- 19.8%, and mean DLCO% of predicted was 61.6 +/- 16.8%. The most common associated disease was ischemic heart disease, found in 43.9% of patients. Duration of symptoms in patients with ischemic heart disease was 25.7 +/- 18.8 months and was as twice long as in the rest of the patients, 12.8 +/- 10.5 months (p < 0.005). Prior the diagnosis of IPF 22 patients (38.6% of cases) did not any receive treatment for symptoms of interstitial lung disease. 31 patients (54.4% of cases) received antibacterial treatment (29 antibiotics and 2 anti-Tb drugs), although there were no clear signs of infection.

CONCLUSIONS

1. Associated ischemic heart disease may cause delay in establishing the diagnosis of IPF; 2. In the period before diagnosis of IPF over half of the patients were given antibacterial treatment without appropriate indications.