IPF acute exacerbations

Risk factors for acute exacerbations in IPF are unclear, but there is evidence that a number of factors may increase risk. Lower total lung capacity, lower forced vital capacity (FVC) and/or lower diffusing capacity of the lung for carbon monoxide (DLco) have been shown to increase the risk of AEx-IPF,^1,2 as has a greater decline in FVC over time.³ GERD, a common comorbidity in patients with IPF, may also contribute to the pathogenesis of IPF through introduction of gastric acid into the respiratory tree.^4,5

References

1. Mura M, Porretta MA, Bargagli E, Sergiacomi G, Zompatori M, Sverzellati N, Taglieri A, Mezzasalma F, Rottoli P, Saltini C, Rogliani P: Predicting survival in newly diagnosed idiopathic pulmonary fibrosis: a 3-year prospective study. Eur Respir J 2012, 40:101–109.
2. Song JW, Hong SB, Lim CM, Koh Y, Kim DS: Acute exacerbation of idiopathic pulmonary fibrosis: incidence, risk factors and outcome. Eur Respir J 2011, 37:356–363.
3. Kondoh Y, Taniguchi H, Katsuta T, Kataoka K, Kimura T, Nishiyama O, Sakamoto K, Johkoh T, Nishimura M, Ono K, Kitaichi M: Risk factors of acute exacerbation of idiopathic pulmonary fibrosis. Sarcoidosis Vasc Diffuse Lung Dis 2010, 27:103–110.
4. Lee JS, Song JW, Wolters PJ, Elicker BM, King TE Jr, Kim DS, Collard HR: Bronchoalveolar lavage pepsin in acute exacerbation of idiopathic pulmonary fibrosis. Eur Respir J 2012, 39:352–358.
5. Tobin RW, Pope CE, Pellegrini CA, Emond MJ, Sillery J, Raghu G: Increased prevalence of gastroesophageal reflux in patients with idiopathic pulmonary fibrosis. Am J Respir Crit Care Med 1998, 158:1804–1808.