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ATS/ERS Criteria for Diagnosis
of Idiopathic Pulmonary Fibrosis (IPF)
in Absence of Surgical Lung Biopsy
Major Criteria
-
Exclusion of
other known causes of ILD such as
certain drug toxicities,
environmental exposures, and
connective tissue diseases
-
Abnormal
pulmonary function studies that
include evidence of restriction
(reduced VC, often with an
increased FEV1/FVC
ratio) and impaired gas exchange
[increased P(A–a)O2,
decreased PaO2 with
rest or exercise or decreased DLCO]
-
Bibasilar
reticular abnormalities with
minimal ground glass opacities on
HRCT scans
-
Transbronchial
lung biopsy or BAL showing no
features to support an alternative
diagnosis
Minor Criteria
-
Age
>50
yr
-
Insidious onset
of otherwise unexplained dyspnea
on exertion
-
Duration of
illness
>3 mo
-
Bibasilar,
inspiratory crackles (dry or
“Velcro”-type in quality)
Definition of
abbreviations
BAL =
bronchoalveolar lavage;
DLCO = diffusing
capacity of the lung for CO;
HRCT =
high-resolution computerized
tomography;
ILD =
interstitial lung disease;
P(A–a)O2
= alveolar–arterial pressure
difference for O2;
VC = vital
capacity.
In the
immunocompetent adult, the presence
of all of the major diagnostic
criteria as well as at least three
of the four minor criteria increases
the likelihood of a correct clinical
diagnosis of IPF.
Related Criteria
Light Criteria for Exudative Pleural Effusion
GINA Classification of Asthma Severity
GOLD Staging
System for Chronic Obstructive Lung
Disease (COPD) Severity
Indications
for Lung Biopsy
ATS/ERS Criteria for Diagnosis
of Idiopathic Pulmonary Fibrosis (IPF)
in Absence of Surgical Lung Biopsy
More...
References:
-
Demedts M, Costabel U.
ATS/ERS international
multidisciplinary
consensus
classification of the
idiopathic
interstitial
pneumonias. Eur Respir
J. 2002
May;19(5):794-6.
[Medline]
-
Demedts M, Wells AU,
Anto JM, Costabel U,
Hubbard R, Cullinan P,
Slabbynck H, Rizzato
G, Poletti V, Verbeken
EK, Thomeer MJ,
Kokkarinen J, Dalphin
JC, Taylor
AN.Interstitial lung
diseases: an
epidemiological
overview. Eur Respir J
Suppl. 2001
Sep;32:2s-16s.
[Medline]
-
American Thoracic
Society; European
Respiratory Society.
American Thoracic
Society/European
Respiratory Society
International
Multidisciplinary
Consensus
Classification of the
Idiopathic
Interstitial
Pneumonias. This joint
statement of the
American Thoracic
Society (ATS), and the
European Respiratory
Society (ERS) was
adopted by the ATS
board of directors,
June 2001 and by the
ERS Executive
Committee, June 2001.
Am J Respir Crit Care
Med. 2002 Jan
15;165(2):277-304.
[Medline]
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