TY - JOUR
T1 - An official American Thoracic Society/European Respiratory Society statement
T2 - Update of the international multidisciplinary classification of the idiopathic interstitial pneumonias
AU - Travis, William D.
AU - Costabel, Ulrich
AU - Hansell, David M.
AU - King, Talmadge E.
AU - Lynch, David A.
AU - Nicholson, Andrew G.
AU - Ryerson, Christopher J.
AU - Ryu, Jay H.
AU - Selman, Moisés
AU - Wells, Athol U.
AU - Behr, Jurgen
AU - Bouros, Demosthenes
AU - Brown, Kevin K.
AU - Colby, Thomas V.
AU - Collard, Harold R.
AU - Cordeiro, Carlos Robalo
AU - Cottin, Vincent
AU - Crestani, Bruno
AU - Drent, Marjolein
AU - Dudden, Rosalind F.
AU - Egan, Jim
AU - Flaherty, Kevin
AU - Hogaboam, Cory
AU - Inoue, Yoshikazu
AU - Johkoh, Takeshi
AU - Kim, Dong Soon
AU - Kitaichi, Masanori
AU - Loyd, James
AU - Martinez, Fernando J.
AU - Myers, Jeffrey
AU - Protzko, Shandra
AU - Raghu, Ganesh
AU - Richeldi, Luca
AU - Sverzellati, Nicola
AU - Swigris, Jeffrey
AU - Valeyre, Dominique
PY - 2013/9/15
Y1 - 2013/9/15
N2 - Background: In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs)definedseven specific entities, andprovided standardized terminology anddiagnosticcriteria. Inaddition, thehistorical "gold standard" of histologic diagnosiswas replaced by amultidisciplinary approach. Since 2002 many publications have provided newinformation about IIPs. Purpose: The objective of this statement is to update the 2002 ATS/ ERS classification of IIPs. Methods: An international multidisciplinary panel was formed and developed key questions that were addressed through a review of the literature published between 2000 and 2011. Results: Substantial progress has been made in IIPs since the previous classification. Nonspecific interstitial pneumonia is now better defined. Respiratory bronchiolitis-interstitial lung disease is now commonly diagnosed without surgical biopsy. The clinical course of idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia is recognized to be heterogeneous. Acute exacerbation of IIPs is now well defined. A substantial percentage of patients with IIP are difficult to classify, often due to mixed patterns of lung injury. A classification based on observed disease behavior is proposed for patients who are difficult to classify or for entities with heterogeneity in clinical course. A group of rare entities, including pleuroparenchymal fibroelastosis and rare histologic patterns, is introduced. The rapidly evolving field of molecular markers is reviewed with the intent of promoting additional investigations that may help in determining diagnosis, and potentially prognosis and treatment. Conclusions: This update is a supplement to the previous 2002 IIP classification document. It outlines advances in the past decade and potential areas for future investigation.
AB - Background: In 2002 the American Thoracic Society/European Respiratory Society (ATS/ERS) classification of idiopathic interstitial pneumonias (IIPs)definedseven specific entities, andprovided standardized terminology anddiagnosticcriteria. Inaddition, thehistorical "gold standard" of histologic diagnosiswas replaced by amultidisciplinary approach. Since 2002 many publications have provided newinformation about IIPs. Purpose: The objective of this statement is to update the 2002 ATS/ ERS classification of IIPs. Methods: An international multidisciplinary panel was formed and developed key questions that were addressed through a review of the literature published between 2000 and 2011. Results: Substantial progress has been made in IIPs since the previous classification. Nonspecific interstitial pneumonia is now better defined. Respiratory bronchiolitis-interstitial lung disease is now commonly diagnosed without surgical biopsy. The clinical course of idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia is recognized to be heterogeneous. Acute exacerbation of IIPs is now well defined. A substantial percentage of patients with IIP are difficult to classify, often due to mixed patterns of lung injury. A classification based on observed disease behavior is proposed for patients who are difficult to classify or for entities with heterogeneity in clinical course. A group of rare entities, including pleuroparenchymal fibroelastosis and rare histologic patterns, is introduced. The rapidly evolving field of molecular markers is reviewed with the intent of promoting additional investigations that may help in determining diagnosis, and potentially prognosis and treatment. Conclusions: This update is a supplement to the previous 2002 IIP classification document. It outlines advances in the past decade and potential areas for future investigation.
KW - Acute interstitial pneumonia
KW - Cryptogenic organizing pneumonia
KW - Desquamative interstitial pneumonia
KW - Idiopathic interstitial pneumonia
KW - Nonspecific interstitial pneumonia
KW - Respiratory bronchiolitis
KW - Usual interstitial pneumonia
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U2 - 10.1164/rccm.201308-1483ST
DO - 10.1164/rccm.201308-1483ST
M3 - Article
C2 - 24032382
AN - SCOPUS:84881669432
SN - 1073-449X
VL - 188
SP - 733
EP - 748
JO - American journal of respiratory and critical care medicine
JF - American journal of respiratory and critical care medicine
IS - 6
ER -