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Pulmonary Fibrosis

IPF or Asthma?

04/23/2010

Question:

I was diagnosed with pulmonary fibrosis after an ER visit because of asthma. Had a bacterial infection in throat/head cold. No one has explained what my prognosis is and what to do about it. Am on asthmanex and other allergy meds. Father died from pneumonitis. Neither of us has smoked. Just read on a site that I may have only 3-5 yrs. to live. Am 67 and very healthy, other than allergies. Panic time!! (am an RN)

Answer:

A confident diagnosis of idiopathic pulmonary fibrosis (IPF) requires a minimum of a high resolution chest CT, pulmonary function tests, and a thorough history and physical examination. In some patients, a lung biopsy is additionally required for a confident diagnosis. There are many conditions that can mimic IPF and so it is advisable to see a pulmonologist, ideally one with a sub-specialization in interstitial lung diseases, so that these other conditions are evaluated for and ruled out.

About 10-15% of patients with IPF will have an inherited form; it is diagnosed the same and treated the same as non-inherited IPF. Asthma and IPF are unrelated but asthma is common enough that a certain percentage of patients with IPF will also have asthma just by chance. Many types of pneumonia can look like IPF by a plain chest x-ray, so it would be important to get repeat x-rays and/or a CT scan after the infection has cleared to be sure that the abnormalities in the emergency department were not simply due to a transient infection.

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Response by:

James N Allen, Jr, MD James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University