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Timing of onset of symptoms in people with idiopathic pulmonary fibrosis
  1. Thomas Hewson,
  2. Tricia M McKeever,
  3. Jack E Gibson,
  4. Vidya Navaratnam,
  5. Richard B Hubbard,
  6. John P Hutchinson
  1. Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
  1. Correspondence to Dr John P Hutchinson, C100 Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK; johnhutch{at}


Little is known about when symptoms of idiopathic pulmonary fibrosis first develop. We identified incident cases of idiopathic pulmonary fibrosis-clinical syndrome (IPF-CS) from a UK primary care database and assessed the frequency of consultations for common symptoms in the 5 years prior to diagnosis. 1671 cases were identified with 5 years of data prior to diagnosis. Breathlessness was the most common symptom, followed by cough. Cases were significantly more likely than controls to experience these symptoms (p<0.001), even 4–5 years before diagnosis (OR for breathlessness for this period 2.79, 95% CI 2.13 to 3.65). This suggests that some patients with IPF may be symptomatic for more than 5 years before diagnosis.

  • idiopathic pulmonary fibrosis
  • clinical epidemiology

Statistics from


  • Competing interests RBH and TMM have received grants from GSK for the PROFILE study, which aims to examine longitudinal disease behaviour and potential biomarkers in IPF. JPH has received funding from GSK for delivering a teaching session on asthma, and from Actelion to attend a two-day preceptorship on pulmonary hypertension. TH, JEG and VN have no competing interests.

  • Ethics approval THIN Scientific Review Committee (SRC 14–047).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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