The multidisciplinary approach in the diagnosis of idiopathic pulmonary fibrosis: a patient case-based review.
Idiopathic pulmonary fibrosis (IPF) is a specific form of chronic, progressively fibrosing interstitial pneumonia that is associated with a significantly worse prognosis than other forms of chronic interstitial pneumonia. An early and accurate diagnosis of IPF is important to enable the initiation of disease-specific therapies, which have the potential to reduce disease progression, and the avoidance of inappropriate and potentially harmful drugs. Establishing an accurate diagnosis of IPF can be challenging. Recent studies and international guidelines advocate the importance of a multidisciplinary team (MDT) in the initial diagnostic assessment of patients with suspected IPF. Typical MDT members include a pulmonologist, a radiologist and a pathologist, with further input from a thoracic surgeon, a rheumatologist, a specialist nurse and an occupational physician where appropriate. Multidisciplinary diagnosis is considered the gold standard because it can improve the accuracy of diagnosis of IPF, avoid unnecessary testing (e.g. lung biopsy), and optimise patient management. Here we highlight the strengths and limitations of the multidisciplinary approach to IPF diagnosis through MDT discussion of two patient cases.
Dept of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy.
Sara
S
Tomassetti
Dept of Radiology, GB Morgagni Hospital, Forlì, Italy.
Sara
S
Piciucchi
Dept of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy.
Paola
P
Tantalocco
Dept of Pathology, GB Morgagni Hospital, Forlì, Italy.
Alessandra
A
Dubini
Dept of Diseases of the Thorax, GB Morgagni Hospital, Forlì, Italy.
Venerino
V
Poletti
D001706:Biopsy; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D014057:Tomography, X-Ray Computed