Recently an X-linked mutation in a third telomerase-associated gene, dyskerin (DKC1), has been described in a family with IPF. Diagnosis
An earlier diagnosis of IPF is a prerequisite for earlier treatment and, potentially, improvement of the long-term clinical outcome of this progressive and ultimately fatal disease. If IPF is suspected, diagnosis can be challenging but a multidisciplinary approach involving a pulmonologist, radiologist and pathologist expert in interstitial lung disease has been shown to improve the accuracy of IPF diagnosis.A Multidisciplinary Consensus Statement on the Idiopathic Interstitial Pneumonias published by the American Thoracic Society (ATS) and the European Respiratory Society (ERS) in 2000 proposed specific major and minor criteria for establishing the diagnosis of IPF. However, in 2011, new simplified and updated criteria for the diagnosis and management of IPF were published by the ATS, ERS, together with the Japanese Respiratory Society (JRS) and Latin American Thoracic Association (ALAT). Currently, a diagnosis of IPF requires:

Exclusion of known causes of ILD, e.g., domestic and occupational environmental exposures, connective tissue disorders, or drug exposure/toxicity
The presence of a typical radiological pattern of usual interstitial pneumonia (UIP) on high-resolution computed tomography (HRCT).In the right clinical setting, it is possible to make the diagnosis of IPF by HRCT alone, obviating the need for surgical lung biopsy.Various technologies using Artificial Intelligence have been developed to help with diagnosis.
Monocytosis is an increase in the number of monocytes circulating in the blood. Monocytes are white blood cells that give rise to macrophages and dendritic cells in the immune system. In humans, monocytosis occurs when there is a sustained rise in monocyte counts greater than 800/mm3 to 1000/mm3.Monocytosis has sometimes been called mononucleosis, but that name is usually reserved specifically for infectious mononucleosis. Causes
Monocytosis often occurs during chronic inflammation. Diseases that produce such a chronic inflammatory state:
Infections: tuberculosis, brucellosis, listeriosis, subacute bacterial endocarditis, syphilis, and other viral infections and many protozoal and rickettsial infections (e.g. kala azar, malaria, Rocky Mountain spotted fever). Blood and immune causes: chronic neutropenia and myeloproliferative disorders. Autoimmune diseases and vasculitis: systemic lupus erythematosus, rheumatoid arthritis and inflammatory bowel disease. Malignancies: Hodgkins disease and certain leukaemias, such as chronic myelomonocytic leukaemia (CMML) and monocytic leukemia. Recovery phase of neutropenia or an acute infection. Obesity (cf. Nagareddy et al. (2014), Cell Metabolism, Vol. 19, pp 821–835)
Miscellaneous causes: sarcoidosis, lipid storage disease and ZNFX1 deficiency.During these stages of extreme inflammation, monocytosis can damage tissues because it increases the activation of the immune response and prevents the inflammation from subsiding which is seen in cases where sepsis occurs. Diagnosis
Blood Test (CBC) (Normal range of Monocytes: 1-10%) (Normal range in males: 0.2-0.8 x 103/microliter)
Blood test checking for monocytosis (Abnormal ranges: >10%) (Abnormal range in males: >0.8 x 103/microliter)

Treatment
Ceftriaxone if there is typhoid fever and levofloxacin or moxifloxacin. Gentamicin and doxycyclin if brucellosis. References


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