AE in IPF

Q: The definition of acute exacerbation(AE) of Idiopathic Pulmonary Fibrosis (IPF) requires a 30 day limit for symptom onset and exclusion of infection?

A) True
B) False


Answer: B

In 2016, the revised definition of AE in IPF by the Idiopathic Pulmonary Fibrosis Network (IPFnet) excluded the previous two requirements from the 2007 definition i.e., an exact 30 day limit for symptom onset and exclusion of infection. In 2016, the proposed definition is"an acute, clinically significant respiratory deterioration characterized by evidence of new widespread alveolar abnormality." The proposed diagnostic criteria are: 

• A known diagnosis of IPF (the diagnosis may be made at the time of acute respiratory deterioration).
• Acute worsening, "typically less than one month's duration" 
•  CT of the chest with new bilateral ground-glass opacification and/or consolidation superimposed on a background of findings consistent with usual interstitial pneumonia (bibasilar reticular opacities associated with honeycomb changes and traction bronchiectasis)  
• Heart failure or fluid overload does not fully explain the worsening.

#pulmonary

Reference:

Collard HR, Ryerson CJ, Corte TJ, et al. Acute Exacerbation of Idiopathic Pulmonary Fibrosis. An International Working Group Report. Am J Respir Crit Care Med 2016; 194:265.