Idiopathic pulmonary fibrosis (IPF) in upper Egypt, a single center study

Aim of work: Idiopathic pulmonary fibrosis (IPF) is the second most common cause of admission to Chest Department at Assiut University hospital, the pattern of presentation, method for diagnosis and Co-morbidities need further studies. Aim: To explore demographic data and pattern of presentation of patients with IPF in upper Egypt and to study the difference from international data. Methods: A total of 568 patients with final diagnosis of IPF were studied, retrospective study was done using the available hospital database for all patients admitted at Assiut University hospital (Tertiary hospital for all upper Egypt Governorates) during the period from 2007 to 2012. Patients with incomplete data were excluded from study, all patients underwent chest X-ray, high resolution computed tomography, spirometry, arterial blood gases, in addition to routine laboratory investigation. Patients with clinical or laboratory evidence of collagen vascular disease or extrinsic allergic alveolitis were excluded from current study. Results: The current study included 568 patients, 191 males and 377 females, mean age 44 ± 12 years. In all cases diagnosis was made according to clinical, spirometry and HRCT chest, no one was subjected to thoracoscopic or bronchoscopic lung biopsy. Most cases were house wife or farmer, 76% of cases were non-smokers, 17% ex-smokers and 7% current smokers, 86% of cases have restrictive spirometry. Usual interstitial pneumonia was the most common high resolution chest computed tomography pattern (51%) (Fig. 5). 39% of cases have at least one Co-morbid disease such as systemic hypertension, ischemic heart disease, pulmonary embolism and/or diabetes mellitus. There was a significant difference between male and female patients with IPF with regard to smoking status (P value < 0.005) and HRCT pattern (P < 0.01). Conclusion: IPF in upper Egypt has a different age and sex distribution compared to international data. Domestic air pollution, indoor exposures or other environmental factors may account for this difference. Lack of local resources for lung biopsy and lack of national guidelines for IPF may also account for this difference. It is highly recommended to establish a national database for patients with IPF in order to plane for national guidelines