Hypersensitivity pneumonitis
| Hypersensitivity Pneumonitis | |
|---|---|
| Other names | Allergic alveolitis, bagpipe lung, extrinsic allergic alveolitis (EAA) |
| High magnification photomicrograph of a lung biopsy taken showing chronic hypersensitivity pneumonitis (H&E), showing mild thickening of the walls of the small air sacs by invasion of white blood cells. A multinucleated giant cell, seen within the walls of the air sacs to the right of the picture halfway down, is an important clue to the correct diagnosis. | |
| Specialty | Pulmonology, Occupational Safety and Health, Occupational Medicine, Immunology |
| Symptoms | Dyspnea, fever, chills, cough, fatigue, weight loss |
| Complications | Chronic interstitial lung disease |
| Usual onset | Hours to years depending on type of exposure. |
| Duration | Hours to years depending on type of exposure. |
| Types | Acute, Subacute, Chronic or Fibrotic vs. Non-fibrotic |
| Causes | Variety of respirable antigens found in farming, food processing, handing of animals, and different occupational settings |
| Diagnostic method | Based on home and environmental exposure history taking followed by imaging, spirometry, serology, bronchoscopy, and even lung biopsy. |
| Differential diagnosis | Idiopathic Pulmonary Fibrosis, Occupational asthma, Sarcoidosis |
| Prevention | Avoidance of antigen exposure |
| Treatment | Avoidance of antigen exposure and sometimes steroids |
Hypersensitivity pneumonitis (HP) or extrinsic allergic alveolitis (EAA) is a syndrome caused by the repetitive inhalation of antigens from the environment in susceptible or sensitized people.[1][2] Common antigens include molds, bacteria, bird droppings, bird feathers, agricultural dusts, bioaerosols and chemicals from paints or plastics.[3] People affected by this type of lung inflammation (pneumonitis) are commonly exposed to the antigens by their occupations, hobbies, the environment and animals.[4][3] The inhaled antigens produce a hypersensitivity immune reaction causing inflammation of the airspaces (alveoli) and small airways (bronchioles) within the lung.[4] Hypersensitivity pneumonitis may eventually lead to interstitial lung disease.[5]
- ^ Cite error: The named reference
Sharmawas invoked but never defined (see the help page). - ^ "Hypersensitivity pneumonitis". Nature Reviews Disease Primers. 6 (1) 66. December 2020. doi:10.1038/s41572-020-0207-8. ISSN 2056-676X. PMID 32764556. S2CID 39174418.
- ^ a b Cite error: The named reference
:1was invoked but never defined (see the help page). - ^ a b Quirce S, Vandenplas O, Campo P, Cruz MJ, de Blay F, Koschel D, et al. (June 2016). "Occupational hypersensitivity pneumonitis: an EAACI position paper". Allergy. 71 (6): 765–779. doi:10.1111/all.12866. hdl:10668/9864. PMID 26913451.
- ^ Ismail T, McSharry C, Boyd G (May 2006). "Extrinsic allergic alveolitis". Respirology. 11 (3): 262–268. doi:10.1111/j.1440-1843.2006.00839.x. PMID 16635083. S2CID 13460021.