The absence of other causes of ILD, presence of UIP on HRCT scan, combination of findings noted on HRCT scan, and interstitial pneumonia pattern noted on lung tissue samples are used to establish a diagnosis of IPF. Per the current diagnostic guidelines from the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society, when evaluating patients for IPF, clinicians should obtain a detailed patient history, order blood tests to exclude connective tissue disease, and perform tracheal lavage and lung biopsy to establish the diagnosis of UIP and to rule out causes of ILD. The American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Society guidelines further recommend a multidisciplinary approach to evaluation.
Positive findings of PE on chest CT angiography and an elevated D-dimer level can be present in patients with IPF, but represent thromboembolic disease and are not part of the constellation of findings used to establish the diagnosis of IPF.
Patients with pneumonia present with infiltrates and radiographic signs of pneumonia on chest x-ray, along with an elevated white blood cell and lactate level.
A widened mediastinum on chest x-ray has a long list of possible causes, including mediastinal adenopathy and possible aortic aneurysm, neither of which is present in IPF.
Learn more about the IPF workup.
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Cite this: Guy W. Soo Hoo. Fast Five Quiz: Diagnosing Idiopathic Pulmonary Fibrosis - Medscape - Feb 04, 2021.