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Diagnosis and Treatment of Combined Pulmonary Fibrosis and Emphysema in 2022

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Chronic obstructive pulmonary disease (COPD) affects an estimated 6.4% and interstitial lung disease (ILD) affects an estimated 0.3% of adults in the US. COPD is defined by airflow obstruction on spirometry, as indicated by a low ratio of forced expiratory volume in the first second to forced vital capacity. Emphysema and chronic bronchitis are the main processes underlying airflow obstruction in COPD. Emphysema is visualized on chest computed tomography (CT) as foci of decreased lung attenuation due to alveolar tissue loss and results in increased lung compliance and volume (hyperinflation). In contrast, most ILDs cause fibroinflammatory parenchymal infiltration that reduces lung compliance and volumes, resulting in a restrictive ventilatory defect on pulmonary function testing. CT findings that indicate ILD include ground-glass/reticular opacities, traction bronchiectasis/bronchiolectasis, or honeycombing.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Jay H. Ryu, MD, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (ryu.jay@mayo.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Cottin  V .  Combined pulmonary fibrosis and emphysema: bad and ugly all the same?   Eur Respir J. 2017;50(1):1700846.PubMedGoogle Scholar
2.
Kumar  A , Cherian  SV , Vassallo  R , Yi  ES , Ryu  JH .  Current concepts in pathogenesis, diagnosis, and management of smoking-related interstitial lung diseases.   Chest. 2018;154(2):394-408.PubMedGoogle ScholarCrossref
3.
Hage  R , Gautschi  F , Steinack  C , Schuurmans  MM .  Combined pulmonary fibrosis and emphysema (CPFE) clinical features and management.   Int J Chron Obstruct Pulmon Dis. 2021;16:167-177.PubMedGoogle ScholarCrossref
4.
Putman  RK , Hatabu  H , Araki  T ,  et al.  Association between interstitial lung abnormalities and all-cause mortality.   JAMA. 2016;315(7):672-681.PubMedGoogle ScholarCrossref
5.
Riley  CM , Sciurba  FC .  Diagnosis and outpatient management of chronic obstructive pulmonary disease: a review.   JAMA. 2019;321(8):786-797.PubMedGoogle ScholarCrossref
6.
Wijsenbeek  M , Cottin  V .  Spectrum of fibrotic lung diseases.   N Engl J Med. 2020;383(10):958-968.PubMedGoogle ScholarCrossref
7.
Waxman  A , Restrepo-Jaramillo  R , Thenappan  T ,  et al.  Inhaled treprostinil in pulmonary hypertension due to interstitial lung disease.   N Engl J Med. 2021;384(4):325-334.PubMedGoogle ScholarCrossref
8.
Wenger  HC , Cifu  AS , Lee  CT .  Home oxygen therapy for adults with chronic obstructive pulmonary disease or interstitial lung disease.   JAMA. 2021;326(17):1738-1739. doi:10.1001/jama.2021.12073PubMedGoogle ScholarCrossref
9.
Dowman  L , Hill  CJ , May  A , Holland  AE .  Pulmonary rehabilitation for interstitial lung disease.   Cochrane Database Syst Reviews. 2014;(10):CD006322. PubMedGoogle Scholar
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