[Early recognition of fibrosing interstitial lung disease: practical recommendations for initial evaluation and...

Fibrosing interstitial lung diseases (ILDs) represent a major diagnostic challenge due to the non-specific nature of their initial symptoms and the frequent delay in diagnosis. Exertional dyspnoea and persistent dry cough are often attributed to more prevalent conditions, which may delay referral. In this context, primary care plays a relevant role in early clinical suspicion and in identifying patients with suggestive findings of ILD. This paper summarises practical recommendations aimed at facilitating the early recognition of these diseases, identifying warning signs and defining criteria for timely referral, highlighting the importance of early clinical suspicion in reducing diagnostic delay and favouring earlier therapeutic intervention. In addition, common errors contributing to diagnostic delay are reviewed, and a basic management pathway applicable to primary care and based on the initial clinical evaluation of these patients is proposed.