It is important to distinguish IPF from fHP because these two conditions have different treatment and outcomes. HRCT imaging of patients with fHP typically demonstrate predominant patchy ground-glass or nodular opacities in a bronchovascular distribution and evidence of expiratory air trapping, whereas patients with IPF demonstrate lower lobe fibrotic changes. In patients with interstitial fibrosis, findings of extensive bilateral ground-glass opacity favor the diagnosis of NSIP, CHP, or desquamative interstitial pneumonia over IPF.
Another important characteristic that distinguishes fHP from IPF is its association with a potential provocative agent. FHP occurs when susceptible individuals develop a delayed fulminant autoimmune response to an inhaled antigen: dust, viruses, bacteria, plants, and fungus. Long-term inflammation leads to fibrosis, mimicking symptoms of IPF.
Consolidation in patients with IPF may suggest overlapping infection or malignancy.
Learn more about the differential diagnosis of CHP.
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Cite this: Guy W. Soo Hoo, Zab Mosenifar. Fast Five Quiz: Idiopathic Pulmonary Fibrosis Differential Diagnosis - Medscape - Jan 26, 2023.
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