TY - JOUR T1 - Idiopathic pulmonary fibrosis: a clinical update JF - British Journal of General Practice JO - Br J Gen Pract SP - 249 LP - 250 DO - 10.3399/bjgp18X696149 VL - 68 IS - 670 AU - Jonathon Shaw AU - Tracey Marshall AU - Helen Morris AU - Nazia Chaudhuri Y1 - 2018/05/01 UR - http://bjgp.org/content/68/670/249.abstract N2 - Idiopathic pulmonary fibrosis (IPF) is the commonest interstitial lung disease (ILD) and is characterised by progressive scarring of the lungs. It typically presents in the sixth or seventh decade.1 The prognosis of IPF is poor and is worse than most cancers, with a median survival from diagnosis of 2.5–3.5 years.1 In 2012, over 5000 people died of IPF in the UK accounting for 1% of all deaths and 4.6% of respiratory deaths.2 On average, a general practice of 10 000 patients will see 2–3 new cases every 3 years,3 although this is likely to be an underestimate, contrasting with 500 per 10 000 for chronic obstructive pulmonary disease (COPD). The rising incidence and prevalence means that GPs will be pivotal in the early detection and long-term management of patients with IPF.Patients with IPF typically present first to their GP. Distinguishing these symptoms from more common conditions such as COPD can be challenging. A history of persistent progressive breathlessness and/or cough in a patient >45 years who may, but not exclusively, have velcro crackles on auscultation and finger clubbing should warrant further management with radiological imaging (chest X-ray and high-resolution computed tomography [Figure 1]) and/or referral to an IPF specialist. … ER -