What are the key diagnostic criteria for idiopathic pulmonary fibrosis in a primary care setting?

Key diagnostic criteria for idiopathic pulmonary fibrosis (IPF) in a primary care setting include:

• Age over 45 years.
• Persistent breathlessness on exertion.
• Persistent cough.
• Bilateral inspiratory crackles on chest auscultation.
• Clubbing of the fingers.
• Spirometry results that are normal or show an impaired restrictive pattern (sometimes obstructive).
• Initial investigations including chest X-ray and lung function tests (spirometry and gas transfer) to assess lung involvement.
• Blood tests to exclude alternative diagnoses such as connective tissue diseases, environmental or occupational lung diseases, and drug-induced lung disease.

Patients with suspected IPF should be referred to a specialist for further assessment including high-resolution CT of the thorax and multidisciplinary team evaluation to confirm diagnosis.

Diagnosis of IPF requires consensus from a multidisciplinary team based on clinical features, lung function, radiological findings, and pathology if indicated.

In primary care, awareness of these clinical features and initial investigations are critical to identify patients who need specialist referral.

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