Lung Fibrosis and Associated Causes: A Primary Care Review Guide

Lung fibrosis (also called pulmonary fibrosis, PF) is a condition where scar tissue builds up in the lungs. This causes the lungs to become stiff, reduces gas exchange, and leads to a restrictive lung defect. Patients usually present with progressive SOB (shortness of breath), reduced exercise tolerance, and often a dry cough.

PF is part of the wider group of interstitial lung diseases (ILDs). There are >200 possible causes, including autoimmune disease, occupational or environmental exposure, infection, radiotherapy, and adverse drug reactions. When no cause is found after appropriate assessment, it is called idiopathic pulmonary fibrosis (IPF).

This is an important primary care topic. GPs need to suspect lung fibrosis early, look for associated causes, identify possible drug triggers, arrange initial investigation, and make a timely respiratory referral. Delay in recognition can lead to missed opportunities for earlier diagnosis, supportive care, and disease-specific treatment.

For the RCGP AKT, lung fibrosis may appear as:

• Restrictive spirometry interpretation

• Differential diagnosis of chronic breathlessness

• Recognition of drug-induced lung disease

• Choosing the right referral pathway

Pulmonary fibrosis (PF) develops after repeated injury to alveolar epithelium (air-sac lining)...