Systematic-Review-Drug-Efficiency-Dissertation-Sample-Work-Tutors-India

2.2.5 Signs and symptoms
The diagnosis of IPF is rare before the age of fifty and its incidence enhances with age
and the mean age at diagnosis is 67 years. Nearly 75% of the patients are males and 2/3 are
smokers or previous smokers (Hyldgaard et al., 2014; Raghu et al., 2011).
IPF comprises of classic signs like progressive dry cough and dyspnea, basically
diminishing over months. The symptoms are present for many years in few patients before
they contact a physician or are referred for investigations. Initially, the symptoms are
generally experienced with regards to exercise, but later even the slightest movement can
result in severe cough, dyspnea and desaturation. Though weight loss is not classical, it may
be observed in the extreme stage of the disease when the respiratory work load enhances.
Cancer needs to be always excluded in such cases. Few patients have experienced repetitive
“airway infections” previous to the diagnosis frequently characterized by enhanced cough
and phlegm, dyspnea and crackles at lung auscultation, but without exceptionally increased
C-reactive protein or fever. The symptoms are rarely refined with antibiotic therapy and
should possibly be depicted as minor acute worsening of IPF (Bendstrup et al., 2014).
There are few subtle or non-existing clinical findings during the initiation of the
disease, but may comprise of clubbing and basal velcro crackles (Cordier & Cottin, 2013).
These observations may be previous to the respiratory symptoms for numerous months. It is
significant to look for extra pulmonary indications of connective tissue disease, as this may
exclude IPF but rather classify the lung disease as associated to the rheumatologic disease.
The differential diagnosis is significant since prognosis and treatment of ILD associated to
connective tissue diseases are distinct from that of IPF. The chronic respiratory deficiency
usually evolves with cyanosis when pulmonary function becomes severely diminished,
during the start of exercise, but may exist later also at rest. Pulmonary hypertension may lead
to peripheral increased dyspnea, edemas, need of oxygen and diminishing diffusion capability,
which is a comparatively common complication to severe IPF and a dangerous prognostic
sign (Raghu et al., 2011).
© 2017-2018 All Rights Reserved, No part of this document should be modified/used without prior consent
Tutors India - Your trusted mentor since 2001
www.tutorindia.com I UK # +44-1143520021, info@tutorsindia.com
Page 28 of 172