Hypersensitivity Pneumonitis: A Pictorial Review Based on the New ATS/JRS/ALAT Clinical Practice Guideline for Radiologists and Pulmonologists

Jehangir, Maham; Khoshpouri, Pegah; Chalian, Hamid

doi:10.3390/diagnostics12112874

Cited by 4 publications

(7 citation statements)

References 44 publications

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“…Similar to our findings, the lymphocyte ratio in BAL was 19.18% in the fibrotic group, whereas it was 29.23% in the nonfibrotic group 25 . According to Dabir et al stated that VC and diffusion capacity decrease in both fibrotic and non‐fibrotic types, and decrease more, older, lymphocyte ratio lower, unknown antigen more common in fibrotic type 26 . Lacasse et al found that when classifying patients based on a combination of clinical features, imaging, and pathophysiology, those with a sub‐acute presentation were particularly difficult to define and that a two‐category model was a better fit.…”

Section: Discussionsupporting

confidence: 89%

“… 25 According to Dabir et al stated that VC and diffusion capacity decrease in both fibrotic and non‐fibrotic types, and decrease more, older, lymphocyte ratio lower, unknown antigen more common in fibrotic type. 26 Lacasse et al found that when classifying patients based on a combination of clinical features, imaging, and pathophysiology, those with a sub‐acute presentation were particularly difficult to define and that a two‐category model was a better fit. Cluster 1 comprised patients with recurrent and systemic symptoms including chest tightness, shortly after antigen exposure, with a greater likelihood of normal imaging, and Cluster 2 comprised advanced fibrotic disease with inspiratory crackles, clubbing, and low lung function.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of cases with hypersensitivity pneumonia: 10 year analysis

Koyuncu

Sarı

Şimşek

2023

Clinical Respiratory J

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Introduction The aim of this study was to examine the clinical features of hypersensitivity pneumonia (HP) cases, diagnostic methods, and related conditions in our hospital, which is a reference clinic in Turkey for chest disease. Methods The population of this retrospective cross‐sectional study consists of all hypersensitivity pneumonia patients followed in a tertiary hospital between 2010 and 2019. The data of 78 patients were included in the analysis. Data were grouped by source of exposure (occupational, environmental, and cryptogenic) by examining the files of the patients. Results Occupational risk factors were detected in 29 (37.2%) of the cases, environmental risk factors were found in 24 (30.8%) cases, neither occupational nor environmental risk factors were detected in 25 (32%) cases, and they were evaluated as cryptogenic. The time from the onset of symptoms to diagnosis was 15.8 ± 26.6 months. The time from the onset of symptoms to diagnosis was found to be longer in the group with occupational risk factors compared with the other groups and was statistically significant (0.044). Conclusion HP is a immune‐mediated interstitial lung disease induced by repeated exposure to environmental and occupational antigens. Etiological agent can be detected in HP patients by detailed questioning of occupational and environmental exposure that may be associated with the onset of symptoms in cases with suspected HP.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Evaluation of cases with hypersensitivity pneumonia: 10 year analysis

Koyuncu

Sarı

Şimşek

2023

Clinical Respiratory J

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“…A fundamental aspect that deserves high attention to avoid over-diagnosis leading to over-treatments is that a high number of individuals exposed to an offending antigen develop an antigen-specific immune response, limited to the presence of serum IgG antibodies and an increased number of lymphocytes in the lung, without ever subsequently developing the pulmonary disease. This premise remains crucial for understanding that the host's response is fundamental to the disease's development [5,6].…”

Section: Definition Epidemiology the "Transition Of Classification" C...mentioning

confidence: 99%

“…Identifying the responsible antigen is more challenging, and the functional state is generally more compromised. BAL may reveal a pattern of lower or absent lymphocytosis, and sometimes an increase in neutrophils and eosinophils, characteristic of a worse prognosis phenotype [5].…”

Section: Definition Epidemiology the "Transition Of Classification" C...mentioning

confidence: 99%

The Unveiled Triad: Clinical, Radiological and Pathological Insights into Hypersensitivity Pneumonitis

Rea,

Bocchino,

Lieto

et al. 2024

JCM

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Hypersensitivity pneumonitis (HP) is a diffuse parenchymal lung disease (DLPD) characterized by complex interstitial lung damage with polymorphic and protean inflammatory aspects affecting lung tissue targets including small airways, the interstitium, alveolar compartments and vascular structures. HP shares clinical and often radiological features with other lung diseases in acute or chronic forms. In its natural temporal evolution, if specific therapy is not initiated promptly, HP leads to progressive fibrotic damage with reduced lung volumes and impaired gas exchange. The prevalence of HP varies considerably worldwide, influenced by factors like imprecise disease classification, diagnostic method limitations for obtaining a confident diagnosis, diagnostic limitations in the correct processing of high-resolution computed tomography (HRCT) radiological parameters, unreliable medical history, diverse geographical conditions, heterogeneous agricultural and industrial practices and occasionally ineffective individual protections regarding occupational exposures and host risk factors. The aim of this review is to present an accurate and detailed 360-degree analysis of HP considering HRCT patterns and the role of the broncho-alveolar lavage (BAL), without neglecting biopsy and anatomopathological aspects and future technological developments that could make the diagnosis of this disease less challenging.

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“…A combination of clinical symptoms, exposure history, and imaging or lung function testing is usually used to make the diagnosis of HP. Treatment may include avoiding further contact with moldy dust or the triggered stimulus, as well as administering corticosteroids or other immunosuppressive medications [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Approach to Hypersensitivity Pneumonitis: A Report of Two Cases

Rachid,

Hindi,

Fikri

et al. 2023

Cureus

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Hypersensitivity pneumonitis (HP) is a bronchopulmonary granulomatosis of immunological mechanism, caused by an aberrant response to an inhaled exposure, which results in mostly T cell-mediated inflammation, granuloma formation, and fibrosis in some cases. The most common forms are bird breeder's disease and farmer's lung disease. The diagnosis of HP is based on the presence of compatible symptoms, the notion of exposure to antigens known to be pathogenic, and the existence of interstitial and bronchiolar images on the thoracic scan, lymphocytosis in the alveolar lavage, and precipitins. Chronic forms, in case of insidious exposure, especially in poultry, may evolve into pulmonary fibrosis with a poor prognosis. Through this work, we want to underline the frequency of this disease in our country, its heterogeneity as well as the difficult early diagnosis. Finally, we will investigate the therapeutic effect of corticosteroids in the early stages and the antifibrotic treatment in fibrotic forms.

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Hypersensitivity Pneumonitis: A Pictorial Review Based on the New ATS/JRS/ALAT Clinical Practice Guideline for Radiologists and Pulmonologists

Cited by 4 publications

References 44 publications

Evaluation of cases with hypersensitivity pneumonia: 10 year analysis

Evaluation of cases with hypersensitivity pneumonia: 10 year analysis

The Unveiled Triad: Clinical, Radiological and Pathological Insights into Hypersensitivity Pneumonitis

Diagnostic Approach to Hypersensitivity Pneumonitis: A Report of Two Cases

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