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histological pattern of UIP in the examination of lung tissue acquired by surgical lung biopsy,
or radiological confirmation of a UIP pattern on the high resolution computed tomography
(HRCT) or both.
The pulmonologists, pathologists and radiologists accomplished that the
multidisciplinary assessment in the diagnosis and management of DILD can enhance the
diagnostic precision, which currently is a broadly assumed proposal for demonstrating the
diagnosis (Flaherty et al., 2007; Raghu et al., 2011).
2.2.8.1 Clinical Characteristics and Additional Tests
The clinical representation of IPF is generally indicated by progressive dyspnea on
exertion and has a subtle onset, usually assisted by non-productive cough. The occurrence of
the symptoms is gradual, but aggravates over time. There is an inconsistent retard between
the onset of symptoms and the final diagnosis, and it may occur between 6 months and two
years (Kim, 2006). An auxiliary diagnosis is traced to be caused by the existence of systemic
symptoms/signs. In 90% of patients crackles can be heard on auscultation and in 50% of
patients acropachy is determined (Xaubet et al., 2003a).
No particular laboratory deformities exist for this disease. Nevertheless, certain signs
or symptoms of connective tissue diseases in their deprivation, serological autoimmune tests
should be conducted in all patients.2 The positive rheumatoid factor or anti-nuclear
antibodies can be discerned in up to 20% of IPF cases (Xaubet et al., 2003a). The existence
of serum specific IgG should be evaluated consistently against the antigens that can most
frequently cause hypersensitivity pneumonitis, since its clinical illustrations are at times
similar to those of IPF. If any of these are positive, in the situation of reasonable exposure
and bronchoalveolar lavage (BAL) with an enhanced lymphocyte count, an irritation test
against the antigen in question and/or surgical lung biopsy should be conducted, in order to
affirm or reject the diagnosis of chronic hypersensitivity pneumonia (Xaubet et al., 2003a).
The probability of employing new biomarkers in the depiction and diagnosis of this disease
has also obtained concern in the current years. Few biomarkers like KL-6, SP-A and SP-D,
circulating fibrocytes and metalloproteinases 1 and 7 are being presently researched (Rosas et
al., 2008; van den Blink et al., 2010).
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