Source: Annual Congress 2011 - Bronchoalveolar lavage and biomarkers in diffuse parenchymal lung disease
Disease area: Interstitial lung diseases

Abstract

Background: The 2002 ATS/ERS Consensus Classification has been widely accepted as the standard classification for interstitial lung diseases (ILD). However, the diagnostic accuracy of the major/minor criteria in the ATS/ERS Classification for idiopathic pulmonary fibrosis (IPF) is still controversial.
Aims and objectives: To evaluate the reliability of the major/minor criteria in the ATS/ERS Classification for IPF.
Methods: Patients with ILD admitted to Ruhrlandklinik (Essen, Germany) were retrospectively studied. All patients presenting with an insidious onset and a duration of illness of >3 months were included. Because of the concept that the exclusion of known causes for ILD is not always easy, we also enrolled patients with secondary ILD (dust/drug exposure or CVD-associated). The diagnostic accuracy of the major/minor criteria for IPF was evaluated.
Results: A total of 163 patients with suspected ILD were studied. The final diagnoses of the enrolled patients were IPF (n=82), other IIP (n=42) and secondary ILD (n=39). In the univariate analysis, the p-value of the criteria (%VC<80%,%TLC<80%,%D_LCO<80%, A-aD_O2>=25Torr, PaO₂<60Torr, typical findings for IPF in HRCT, BAL lymphocytosis <30% age>50, and bibasilar crackles) for the diagnosis of IPF were 0.04, 0.94, 0.65, 0.08, 0.29, <0.0001, <0.0001, 0.97, and 0.0015, respectively. In the multivariate analysis, the typical findings for IPF on HRCT (p<0.0001) and BAL lymphocytosis <30% (p=0.0001) showed independent diagnostic significance for IPF.
Conclusions: Typical findings for IPF in HRCT and BAL lymphocytosis <30% were of diagnostic significance for IPF.

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S. Ohshimo, F. Bonella, K. Tanigawa, N. Kohno, J. Guzman, U. Costabel (Essen, Bochum, Germany; Hiroshima, Japan). Reliability of ATS/ERS criteria for the diagnosis of idiopathic pulmonary fibrosis. Eur Respir J 2011; 38: Suppl. 55, 4778

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