Management of interstitial lung disease: an audit at a university teaching hospital in Saudi Arabia.
To assess the management of interstitial lung disease (ILD) in relation to the published guidelines 122 consecutive cases were analyzed. Clinical features and non-invasive laboratory tests led to the diagnosis in nearly one sixth of the patients (16%), mainly CTD and a few miscellaneous disorders. In another sixth the diagnosis was reached by means of a transbronchial lung biopsy, particularly in sarcoidosis. Nearly a third had surgical lung biopsies, which were diagnostic in 98%. The diagnoses were reached in 82 patients (67%) and include: cryptogenic fibrosing alveolitis (20), sarcoidosis (16), connective tissue disease (17) and miscellaneous (29). The remaining third were undiagnosed, and this group had a higher mean age and was much less likely to receive immunosuppressive therapy than any group with a specific diagnosis. It is concluded that while physicians reached a specific diagnosis in most cases of ILD, commonly through a lung biopsy. A sizeable proportion (nearly a third), or remained undiagnosed and those were less likely to be treated and had a poorer prognosis. The availability of less invasive techniques should encourage physicians to obtain a biopsy since this is likely to lead to a more active approach to therapy.
al-Mobeireek
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Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
D000046:Academic Medical Centers / Q000458:organization & administration; D000367:Age Factors; D000368:Aged; D001706:Biopsy / Q000379:methods; D005260:Female; D019983:Guideline Adherence / Q000592:standards*; D006801:Humans; D008168:Lung / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000145:classification / Q000175:diagnosis* / Q000628:therapy; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000458:organization & administration; D012529:Saudi Arabia