Symptoms and referral

Patients with idiopathic pulmonary fibrosis (IPF) often present with general respiratory symptoms that can lead to an initial misdiagnosis of asthma, chronic obstructive pulmonary disease or pneumonia, among other diseases.16

Key IPF symptoms

IPF should be considered in all adult patients who have the following symptoms, in the absence of any additional symptoms that suggest a multisystem disease:17

  • unexplained chronic exertional dyspnoea
  • persistent cough
  • bibasilar inspiratory (Velcro-like) crackles when listening to the chest
  • finger clubbing


Reasons for referral delays

Delays between the onset of first symptoms and referral to a specialist centre are common with patients with IPF and can be due to:16,18

  • patient-dependent factors (for example, reluctance to acknowledge symptoms that may indicate health problems and a sedentary lifestyle masking dyspnoea at exercise)
  • disease-dependent factors (for example, progressive onset and slow progression of IPF allows the disease to go undetected unless exacerbations occur)
  • physician-dependent factors (for example, lack of awareness of rare diseases by general practitioners and even by lung specialists)


Bibasilar inspiratory (Velcro-like) crackles

The detection of bibasilar inspiratory (Velcro-like) crackles during chest auscultation, which are strongly associated with the presence of lung fibrosis, has been proposed as a potential measure to improve early detection of IPF.16,18

Find out more about the diagnosis of IPF
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