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Hypersensitivity Pneumonitis

Han Q. Bui, MD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Hypersensitivity pneumonitis (HP) is also called extrinsic allergic alveolitis (EAA).

  • HP is a diffuse inflammatory disease of the lung parenchyma caused by an immunologic reaction to ...

DIAGNOSIS

  • Diagnosis criteria most widely used but not validated: (i) history and physical and pulmonary function tests (PFTs) indicating restriction or diffusion disease, (ii) radiologic imaging conse...

TREATMENT

GENERAL MEASURES

Outpatient, except for acute pneumonitis cases and admission for workup (BAL, lung biopsy) 

MEDICATION

First Line

  • Avoidance of offending antigen is primary therapy and results i...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Initial follow-up should be weekly to monthly, depending on severity and course.

  • Follow treatments with serial CXR, PFTs, and circulating antibod...

REFERENCES

1
Girard M, Cormier Y. Hypersensitivity pneumonitis. Curr Opin Allergy Clin Immunol.  2010;10(2):99–103. [View Abstract on OvidMedline]
2
Costabel U, Bonella F, Guzman J. Chronic hypersen...

CODES

ICD10

  • J67.9 Hypersensitivity pneumonitis due to unspecified organic dust

  • J67.0 Farmer’s lung

  • J67.2 Bird fancier’s lung

  • J67.8 Hypersensitivity pneumonitis due to other organic dusts

  • J67.5 Mushroom-wor...

CLINICAL PEARLS

  • Skin testing is not useful for the diagnosis of HP.

  • Diagnosis should be suspected in every patient with unexplained cough and dyspnea on exertion, functional impairment (restriction or ...

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