Hypersensitivity pneumonitis: Current concepts and future questions

Patel, Ashok; Ryu, Jay H.; Reed, Charles E.

doi:10.1067/mai.2001.119570

Cited by 267 publications

(210 citation statements)

References 78 publications

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“…The pathogenesis of HP is complex but airborne particles that cause HP are less than 3 μm in size, a size that easily reaches the lung parenchyma (Yi, 2002). Since a small proportion of exposed persons (<10%) (Mohr, 2004) develop HP, there may be genetic predisposition of the host in addition to environmental exposure (Ando et al, 1999;Patel et al, 2001;Girard et al, 2004;Mohr, 2004;Jacobs et al, 2005). The nature of the genetic predisposition is unclear, but MHC and TNF-α polymorphism is seen in HP patients compared to normal but exposed cohorts (Camarena et al, 2001;Schuyler, 2001).…”

Section: Hypersensitivity Pneumonitismentioning

confidence: 99%

“…HP is caused by repeated inhalation of a sensitizing agent (Wild and Lopez, 2001;Yi et al, 2002;Lacasse et al, 2003;Mohr, 2004). Although, there are many inciting agents that cause HP/EAA, the most common are inhaled organic substances and less commonly low molecular weight chemicals (Thomeer et al, EXOGENOUS CAUSES OF PULMONARY FIBROSIS 87 (Ando et al, 1999;Patel et al, 2001;Camus et al, 2004aCamus et al, , 2004b (Table 1). It is not uncommon for this type of lung reaction to be ascribed a name based on the source of exposure or the avocation in which the exposure occurred (Table 1).…”

Section: Hypersensitivity Pneumonitismentioning

confidence: 99%

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Environmental, Inhaled and Ingested Causes of Pulmonary Fibrosis

et al. 2007

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Pulmonary fibrosis is a general term that refers to a collection of connective tissue around alveolar structures. There are over 200 disorders where the lungs may be involved in a fibrotic response. To determine the cause of pulmonary fibrosis requires an in depth understanding of the pathogenesis of pulmonary fibrosis and breadth of knowledge of the causative agents and associated disorders that may lead to pulmonary fibrosis. A comprehensive evaluation of the patient is absolutely essential, starting with detailed history that includes an occupational and environmental history because fibrogenic exposures can occur in many settings. Equally important is a history of ingestion of pharmaceutical or nonpharmaceutical substances. A physical examination and judicious investigations are always a part of any comprehensive clinical assessment but they are not commonly helpful in elucidating the cause of most pulmonary fibrotic disorders. Although, a chest film is invariably done, a logical and strongly recommended next step is a high-resolution computed tomography (HRCT). HRCT provides a better assessment of the radiological pattern, may suggest a diagnosis as well as direct the site, and type of lung biopsy. If the history and investigations do not lead to a diagnosis then a lung biopsy is required. Prevention or removal of the inciting agent is critical to the treatment of these disorders and in some instances corticosteroids may be of help.

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Section: Hypersensitivity Pneumonitismentioning

confidence: 99%

Section: Hypersensitivity Pneumonitismentioning

confidence: 99%

Environmental, Inhaled and Ingested Causes of Pulmonary Fibrosis

et al. 2007

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“…For those with severe manifestations of acute HP, antigen avoidance in conjunction with prednisone (40-60 mg/d for 1 to 2 weeks and then tapered for 4 to 6 weeks) is recommended. 6 Systemic corticosteroids are also recommended for patients with severe or progressive chronic HP, but therapeutic efficacy is variable. 7 Once the diagnosis of HP is suspected, complete and immediate avoidance of the offending antigen is mandatory.…”

Section: Which One Of the Following Treatments Would Be Most Approprimentioning

confidence: 99%

73-Year-Old Woman With Progressive Shortness of Breath

Maniaci

Johnson

2010

Mayo Clinic Proceedings

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“…Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is a syndromethat results from repeated inhalation of various causative antigens (1)(2)(3). The term humidifier lung, also known as humidifier fever or Mondaymorning sickness, is applied to cases of HP caused by inhalational exposure to contaminated ventilation units (1)(2)(3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

“…The term humidifier lung, also known as humidifier fever or Mondaymorning sickness, is applied to cases of HP caused by inhalational exposure to contaminated ventilation units (1)(2)(3)(4)(5)(6)(7). In general, prolonged exposure to contaminating fungal antigen results in immune sensitization and causes immune-mediated lung injury in susceptible individuals.…”

Section: Introductionmentioning

confidence: 99%

Humidifier Lung: Possible Contribution of Endotoxin-induced Lung Injury.

et al. 2002

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A 56-year-old man was admitted with cough, fever, myalgia, and arthralgia. Chest computed tomography demonstrated bilateral diffuse ground-glass opacities predominantly in the upper lungs. Subpleural non-segmental consolidation was observed in the late phase. Hypersensitivity pneumonitis was suspected, and an environmental provocation test with the incidental use of a home ultrasonic humidifier was positive. Unlike typical hypersensitivity pneumonitis, serum KL-6 levels were normal. Although several microorganisms were isolated from the humidifier water, there was no evidence for immunesensitization. Wedetected high amounts of endotoxin in the humidifier water, which mayhave contributed to the lung injury of this patient.

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Hypersensitivity pneumonitis: Current concepts and future questions

Cited by 267 publications

References 78 publications

Environmental, Inhaled and Ingested Causes of Pulmonary Fibrosis

Environmental, Inhaled and Ingested Causes of Pulmonary Fibrosis

73-Year-Old Woman With Progressive Shortness of Breath

Humidifier Lung: Possible Contribution of Endotoxin-induced Lung Injury.

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