Management of interstitial lung disease: an audit at a university teaching hospital in Saudi Arabia.

ABSTRACT

To assess the management of interstitial lung disease (ILD) in relation to the published guidelines 122 consecutive cases were analyzed. Clinical features and non-invasive laboratory tests led to the diagnosis in nearly one sixth of the patients (16%), mainly CTD and a few miscellaneous disorders. In another sixth the diagnosis was reached by means of a transbronchial lung biopsy, particularly in sarcoidosis. Nearly a third had surgical lung biopsies, which were diagnostic in 98%. The diagnoses were reached in 82 patients (67%) and include cryptogenic fibrosing alveolitis (20), sarcoidosis (16), connective tissue disease (17) and miscellaneous (29). The remaining third were undiagnosed, and this group had a higher mean age and was much less likely to receive immunosuppressive therapy than any group with a specific diagnosis. It is concluded that while physicians reached a specific diagnosis in most cases of ILD, commonly through a lung biopsy. A sizeable proportion (nearly a third), or remained undiagnosed and those were less likely to be treated and had a poorer prognosis. The availability of less invasive techniques should encourage physicians to obtain a biopsy since this is likely to lead to a more active approach to therapy.