IPF SYMPTOMATOLOGY

Since Idiopathic Pulmonary Fibrosis (IPF) may not be a single disease, it is not surprising that disease symptoms may vary among patients. Also in the same patient the symptoms may differ with the stage of the disease. A chronic postnasal drip was my first symptom. I attributed subsequent attacks of non-productive cough to throat irritation caused by nasal discharge due to sinus infection. I consulted otorhinolaryngologist who found no evidence of any sinus disease. The persistent cough attacks in the mornings led my family physician to refer me to a radiologist for a chest X-ray and subsequently to a cardiologist because of slight right heart enlargement. Cardiologist found no evidence of heart failure and referred me to a pulmonologist who made a tentative diagnosis of IPF on the basis of X-ray, catscan and pulmonary function test.
At ca 3 years after the initial diagnosis I first experienced oxygen desaturation on exercise. Now, at 8 years after diagnosis, this is my major symptom. My arterial blood oxygen levels decrease from 95% at rest to as low as 83% after a few steps around the house. Desaturation is always associated with tachycardia, my heart increases from 70 or 80 beats/min to 110 or even 120 beats/min. Oxygen inhalation reduces desaturation effect but not necessarily cardiac acceleration. Postnasal drip is now replaced by frontal nasal discharge that is enhanced by oxygen inhalation. Another symptom at the late stage of the disease is a disturbance in temperature regulation. A burning feet sensation appears to be independent of either oxygen saturation levels or of actual skin temperature. If oxygen saturation is lowered below 90% an attack of dry cough is likely to follow, but occasionally I had cough attacks even at normal blood oxygen levels. Another symptom of the disease is weight loss; I started to loose weight at ca 6 years after diagnosis and lost ca 25 pounds within the last two years.
Hypersensitivity diseases are often associated with skin eruptions. I experienced eruptions in anal region that responded to local antihistaminics or steroids. These eruptions may indicate hypersensitivity to a dietary component, cytokine or a bacterial toxin. They may conceivably help in the elucidation of the etiology of my disease.