Table 6. Main examinations that are useful for idiopathic pulmonary fibrosis (IPF) diagnosis and management
At IPF diagnosis
    Systematic
        Chest HRCT
        FVC and DLCO
        Doppler echocardiography
        Biology
            Antinuclear antibodies
            Anti-citrullinated cyclic peptides antibodies
            Rheumatoid factor
            Differential blood cell count
            C-reactive protein
            Serum creatinine
            Transaminases, γ-glutamyltransferase and alkaline phosphatases
    Occasional
        Video-assisted surgical lung biopsy (see text)
        Differential cell count of BAL (see text)
        TLC and arterial blood gas in room air at rest
        6MWT with measurement of percutaneous oxygen saturation
    Depending on context
        Genetic testing (see text)
        Anti-neutrophil cytoplasmic antibodies
        Anti-SSA and anti-SSB antibodies
        Anti-centromere and anti-topoisomerase antibodies
        Anti-Mi-2, anti-U3RNP and anti-ARNt synthetase antibodies
        Creatine phosphokinase
        Anti-thyroid antibodies
        Precipitines (depending on disease presentation)
        Microbiology of BAL
        Electrophoresis of serum proteins, immuno-electrophoresis of serum proteins, urine immunofixation and cryoglobulinaemia
        Exploration for gastro-oesophageal reflux
        Exploration for sleep apnoea syndrome
During follow-up
    Every 3 to 6 months
        FVC and DLCO
    Depending on context
        Chest HRCT
        Doppler echocardiography
        TLC
        Arterial blood gas in room air
        Right heart catheterisation (see text)
  • HRCT: high-resolution computed tomography; FVC: forced vital capacity; DLCO: diffusing capacity of the lung for carbon monoxide; BAL: bronchoalveolar lavage; TLC: total lung capacity; 6MWT: 6-min walk test.