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Fibrotic Hypersensitivity Pneumonitis: Key Issues in Diagnosis and Management.


ABSTRACT: The diagnosis of hypersensitivity pneumonitis (HP) relies on the clinical evaluation of a number of features, including a history of significant exposure to potentially causative antigens, physical examination, chest CT scan appearances, bronchoalveolar lavage lymphocytosis, and, in selected cases, histology. The presence of fibrosis is associated with higher morbidity and mortality. Differentiating fibrotic HP from the idiopathic interstitial pneumonias can be a challenge. Furthermore, even in the context of a clear diagnosis of fibrotic HP, the disease behaviour can parallel that of idiopathic pulmonary fibrosis in a subgroup, with inexorable progression despite treatment. We review the current knowledge on the diagnosis, management, and prognosis of HP with particular focus on the fibrotic phenotype.

SUBMITTER: Kouranos V 

PROVIDER: S-EPMC5483872 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Fibrotic Hypersensitivity Pneumonitis: Key Issues in Diagnosis and Management.

Kouranos Vasileios V   Jacob Joseph J   Nicholson Andrew A   Renzoni Elizabetta E  

Journal of clinical medicine 20170615 6


The diagnosis of hypersensitivity pneumonitis (HP) relies on the clinical evaluation of a number of features, including a history of significant exposure to potentially causative antigens, physical examination, chest CT scan appearances, bronchoalveolar lavage lymphocytosis, and, in selected cases, histology. The presence of fibrosis is associated with higher morbidity and mortality. Differentiating fibrotic HP from the idiopathic interstitial pneumonias can be a challenge. Furthermore, even in  ...[more]

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