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Pulmonary function and fitness years after treatment for hypersensitivity pneumonitis during childhood
Author(s) -
Sisman Yagmur,
Buchvald Frederik,
Blyme Anne Katrine,
Mortensen Jann,
Nielsen Kim Gjerum
Publication year - 2016
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.23360
Subject(s) - medicine , spirometry , diffusing capacity , hypersensitivity pneumonitis , pulmonary function testing , vital capacity , lung volumes , respiratory system , dlco , cardiology , respiratory disease , gastroenterology , lung , asthma , lung function
Summary Background Hypersensitivity pneumonitis (HP) is an immune‐mediated diffuse lung disease. Significant improvement in lung function and diffusing capacity after treatment was previously demonstrated, while long‐term data focusing specifically on peripheral airway impairment and peak oxygen uptake (fitness) are lacking. Hence, the aim of this study was to conduct a comprehensive study to determine the stability of pulmonary function and fitness in patients previously diagnosed with HP. Methods We performed a cross‐sectional follow‐up study with inclusion of longitudinal data if available in patients previously diagnosed with biopsy and high‐resolution computed tomography‐verified HP during childhood. We performed multiple breath wash‐out (LCI 2.5 ), spirometry (FEV 1 ), bronchiodilator responsiveness test, diffusing capacity (DL CO and DL CO /V A ), body‐plethysmography (TLC), and peak oxygen uptake (VO 2peak ). St. George Respiratory Questionnaire was used as a measure of respiratory quality of life. Results Twenty two patients were assessed. LCI 2.5 was abnormal in 47.4% compared to abnormal FEV 1 in only 9.1% and without significant bronchiodilator responsiveness. DL CO and TLC were abnormal in 40.9 and 13.6%, respectively, while DL CO /V A was within normal range. Only 11.1% demonstrated abnormal VO 2peak . All longitudinally assessed outcomes remained unchanged between end of treatment and time of follow up. Conclusions A large proportion of patients previously diagnosed with HP had abnormal LCI 2.5 in contrast to normal spirometry. Spirometric outcomes, TLC, and diffusing capacity were persistently slightly reduced, but stable, and VO 2peak was excellent at time of follow‐up. Long‐term prognosis in children with HP appears favorable although persistent peripheral airway involvement of unknown clinical significance was demonstrated in almost half of the patients. Pediatr Pulmonol. 2016;51:830–837 . © 2015 Wiley Periodicals, Inc.