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Hypersensitivity pneumonitis: Current concepts in pathogenesis, diagnosis, and treatment
Author(s) -
Barnes Hayley,
Troy Lauren,
Lee Cathryn T.,
Sperling Anne,
Strek Mary,
Glaspole Ian
Publication year - 2022
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.15017
Subject(s) - medicine , hypersensitivity pneumonitis , bronchoalveolar lavage , honeycombing , lymphocytosis , pathology , fibrosis , immunosuppression , interstitial lung disease , pulmonary fibrosis , immunology , lung
Hypersensitivity pneumonitis is an immune‐mediated interstitial lung disease caused by an aberrant response to an inhaled exposure, which results in mostly T cell–mediated inflammation, granuloma formation, and fibrosis in some cases. HP is diagnosed by exposure identification, HRCT findings of ground‐glass opacities, centrilobular nodules, and mosaic attenuation, with traction bronchiectasis and honeycombing in fibrotic cases. Additional testing including serum IgG testing for the presence of antigen exposure, bronchoalveolar lavage lymphocytosis, and lung biopsy demonstrating granulomas, inflammation, and fibrosis, increases the diagnostic confidence. Treatment for HP includes avoidance of the implicated exposure, immunosuppression, and anti‐fibrotic therapy in select cases. This narrative review presents the recent literature in the understanding of the immunopathological mechanisms, diagnosis, and treatment of HP.