O40-1 Risk of hypersensitivity pneumonitis and other interstitial lung diseases among pigeon breeders

2016 ◽  
Author(s):  
Christine Cramer ◽  
Vivi Schlünssen ◽  
Elisabeth Bendstrup ◽  
Zara Ann Stokholm ◽  
Jesper Medom Vestergaard ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Interstitial Lung Diseases

scholarly journals Presentation, diagnosis and clinical course of the spectrum of progressive-fibrosing interstitial lung diseases

2018 ◽  
Vol 27 (150) ◽  
pp. 180076 ◽  
Author(s):  
Vincent Cottin ◽  
Nikhil A. Hirani ◽  
David L. Hotchkin ◽  
Anoop M. Nambiar ◽  
Takashi Ogura ◽  
...  
Keyword(s):  
Interstitial Pneumonia ◽  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Early Death ◽  
Occupational Exposures ◽  
Interstitial Lung Diseases ◽  
Lung Function Decline ◽  
Nonspecific Interstitial Pneumonia ◽  
Immunomodulatory Therapies

Although these conditions are rare, a proportion of patients with interstitial lung diseases (ILDs) may develop a progressive-fibrosing phenotype. Progressive fibrosis is associated with worsening respiratory symptoms, lung function decline, limited response to immunomodulatory therapies, decreased quality of life and, potentially, early death. Idiopathic pulmonary fibrosis may be regarded as a model for other progressive-fibrosing ILDs. Here we focus on other ILDs that may present a progressive-fibrosing phenotype, namely idiopathic nonspecific interstitial pneumonia, unclassifiable idiopathic interstitial pneumonia, connective tissue disease-associated ILDs (e.g.rheumatoid arthritis-related ILD), fibrotic chronic hypersensitivity pneumonitis, fibrotic chronic sarcoidosis and ILDs related to other occupational exposures. Differential diagnosis of these ILDs can be challenging, and requires detailed consideration of clinical, radiological and histopathological features. Accurate and early diagnosis is crucial to ensure that patients are treated optimally.

scholarly journals Occupational Extrinsic Allergic Alveolitis in a poultry farmer

2020 ◽  
Vol 71 (1) ◽  
pp. 69-73
Author(s):  
Smărăndescu Raluca Andreea ◽  
Mircea-Constantin Diaconu ◽  
Claudia-Mariana Handra ◽  
Agripina Rașcu
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Chemical Compounds ◽  
Interstitial Lung Diseases ◽  
Risk Exposure ◽  
Low Molecular Weight ◽  
Organic Substances ◽  
Extrinsic Allergic Alveolitis ◽  
Allergic Alveolitis ◽  
The One

AbstractHypersensitivity pneumonitis is a group of inflammatory interstitial lung diseases caused by hypersensitivity immune reactions to the inhalation of various antigens: fungal, bacterial, animal protein, or chemical sources, finely dispersed, with aerodynamic diameter <5μ, representing the respirable fraction. The national register for interstitial lung diseases records very few cases of hypersensitivity pneumonitis (extrinsec allergic alveolitis), a well defined occupational disease. Although not an eminently of occupational origin, the extrinsec allergic alveolitis can occur secondary to occupational exposure to organic substances (animal or insect proteins, bacteria, fungi) or inorganic (low molecular weight chemical compounds) and the occupational doctor is a key actor in the diagnosys. The disease has chronic evolution and exposure avoidance, as early as possible, has major prognostic influence. The occupational anamnesis remains the most important step and the occupational physician is the one in charge for monitoring and detection of the presence of respiratory symptoms in all employees with risk exposure. Next, we present the case of a farmer, without other comorbidities, who develops various respiratory and systemic diseases and manifestations due to repeated exposure to animal proteins and molds, in order to review the risk factors and the consequences of exposure in poultry farms.

scholarly journals Update in Diagnosis and Management of Interstitial Lung Diseases

2021 ◽  
Vol 9 (7) ◽  
Author(s):  
Mauricio Salinas ◽  
Matias Florenzano
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Connective Tissue Diseases ◽  
Interstitial Lung Diseases ◽  
Diverse Group ◽  
Principal Characteristics ◽  
Diagnosis And Management ◽  
New Concepts ◽  
Lung Abnormalities ◽  
Diagnosis Approach

Interstitial lung diseases (ILD) are a complex and diverse group of disorders. ILD are more frequently diagnosed and prevalent now. In this article, diagnosis approach, including new bronchoscopy and genetic tools, and some recently added concepts are revisited, as progressive fibrosing interstitial lung diseases and interstitial lung abnormalities. Recently information relative to idiopathic pulmonary fibrosis is shown, including genetics and pathophysiology. We look over the dynamic world of interstitial lung diseases related to connective tissue diseases, principal characteristics of this group and the principles that define which of the various available therapies should be chosen. Finally new concepts and guidelines published about the diagnosis and management of hypersensitivity pneumonitis are reported. New data and treatments have changed our traditional vision of these lung diseases and we will new options in the next years.

scholarly journals Hypersensitivity Pneumonitis: Diagnostic and Therapeutic Challenges

2021 ◽  
Vol 8 ◽  
Author(s):  
Maria Laura Alberti ◽  
Emily Rincon-Alvarez ◽  
Ivette Buendia-Roldan ◽  
Moises Selman
Keyword(s):  
Genetic Risk ◽  
Lung Diseases ◽  
Inflammatory Process ◽  
Hypersensitivity Pneumonitis ◽  
Interstitial Lung Diseases ◽  
Therapeutic Options ◽  
High Resolution Computed Tomography ◽  
Multidisciplinary Assessment ◽  
Persistent Inflammation ◽  
Antigen Removal

Hypersensitivity pneumonitis (HP) is one of the most common interstitial lung diseases (ILD), that presents unique challenges for a confident diagnosis and limited therapeutic options. The disease is triggered by exposure to a wide variety of inciting antigens in susceptible individuals which results in T-cell hyperactivation and bronchioloalveolar inflammation. However, the genetic risk and the pathogenic mechanisms remain incompletely elucidated. Revised diagnostic criteria have recently been proposed, recommending to classify the disease in fibrotic and non-fibrotic HP which has strong therapeutic and outcome consequences. Confident diagnosis depends on the presence of clinical features of ILD, identification of the antigen(s), typical images on high-resolution computed tomography (HRCT), characteristic histopathological features, and lymphocytosis in the bronchoalveolar lavage. However, identifying the source of antigen is usually challenging, and HRCT and histopathology are often heterogeneous and not typical, supporting the notion that diagnosis should include a multidisciplinary assessment. Antigen removal and treating the inflammatory process is crucial in the progression of the disease since chronic persistent inflammation seems to be one of the mechanisms leading to lung fibrotic remodeling. Fibrotic HP has a few therapeutic options but evidence of efficacy is still scanty. Deciphering the molecular pathobiology of HP will contribute to open new therapeutic avenues and will provide vital insights in the search for novel diagnostic and prognostic biomarkers.

scholarly journals Risk of hypersensitivity pneumonitis and interstitial lung diseases among pigeon breeders

2016 ◽  
Vol 48 (3) ◽  
pp. 818-825 ◽  
Author(s):  
Christine Cramer ◽  
Vivi Schlünssen ◽  
Elisabeth Bendstrup ◽  
Zara Ann Stokholm ◽  
Jesper Medom Vestergaard ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Cox Regression ◽  
Interstitial Lung Diseases ◽  
Protective Measures ◽  
National Patient Registry ◽  
Hazard Ratios ◽  
Increased Risk ◽  
National Patient

We studied the risk of hypersensitivity pneumonitis and other interstitial lung diseases (ILDs) among pigeon breeders.This is a retrospective follow-up study from 1980 to 2013 of 6920 pigeon breeders identified in the records of the Danish Racing Pigeon Association. They were compared with 276 800 individually matched referents randomly drawn from the Danish population. Hospital based diagnoses of hypersensitivity pneumonitis and other ILDs were identified in the National Patient Registry 1977–2013. Stratified Cox regression analyses estimated the hazard ratios (HR) of hypersensitivity pneumonitis and other ILDs adjusted for occupation, residence and redeemed prescription of medication with ILDs as a possible side-effect. Subjects were censored at death, emigration or a diagnosis of connective tissue disease.The overall incidence rate of ILD was 77.4 per 100 000 person-years among the pigeon breeders and 50.0 among the referents. This difference corresponded to an adjusted HR of 1.56 (95% CI 1.26–1.94). The adjusted HRs of hypersensitivity pneumonitis and other ILDs for pigeon breeders were 14.36 (95% CI 8.10–25.44) and 1.33 (95% CI 1.05–1.69), respectively.This study shows an increased risk of ILD among pigeon breeders compared with the referent population. Protective measures are recommended even though ILD leading to hospital contact remains rare among pigeon breeders.

scholarly journals Utility of serological biomarker’ panels for diagnostic accuracy of interstitial lung diseases

2020 ◽  
Vol 68 (6) ◽  
pp. 414-421
Author(s):  
Laura Bergantini ◽  
Miriana d’Alessandro ◽  
Lucia Vietri ◽  
Giuseppe Domenico Rana ◽  
Paolo Cameli ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Differential Diagnosis ◽  
Diagnostic Accuracy ◽  
Regression Model ◽  
Lung Diseases ◽  
Logistic Regression Model ◽  
Hypersensitivity Pneumonitis ◽  
Pulmonary Function Tests ◽  
Interstitial Lung Diseases ◽  
Reactive Protein

AbstractInterstitial lung diseases (ILD) are a heterogeneous group of illnesses of known and unknown aetiology. Differential diagnosis among the three disorders is often challenging. Specific biomarkers with good sensitivity and specificity are therefore needed to predict clinical outcome and guide clinical decisions. The aim of this study was to investigate inflammatory/fibrotic biomarkers, to determine whether single mediators or panels of mediators could be useful to stratify patients into three distinct domains: sarcoidosis, idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis (cHP). A total of 163 ILD patients monitored at Siena Referral Centre for Sarcoidosis and other Interstitial Lung Diseases were enrolled in the study. Clinical data, pulmonary function tests and biochemical analytes were retrospectively collected. SAA levels were detected by ELISA kit and Krebs von den Lungen 6 (KL-6) were measured by CLEIA method, for sarcoidosis, cHP and IPF patients. Multiple comparison analysis showed significant differences in C reactive protein (CRP), white blood cell count (WBC) and creatinine levels between the three groups. In the logistic regression model, KL-6, CRP and WBC showed areas under curves (AUC) 0.86, for sarcoidosis diagnosis. The logistic regression model KL-6 and SAA showed the best performance with an AUC 0.81 for discriminating IPF than cHP and sarcoidosis. For differential diagnosis of IPF and cHP, KL-6 and SAA were considered in the logistic regression model, showed an AUC 0.79. The combination of serum biomarkers proposed here offers insights into the pathobiology of ILDs. These panels of bioindicators will improve diagnostic accuracy and will be useful in the clinical management of ILDs.

scholarly journals Making an Accurate Diagnosis of Chronic Hypersensitivity Pneumonitis

2014 ◽  
Vol 21 (6) ◽  
pp. 370-372 ◽  
Author(s):  
Kerri A Johannson ◽  
Christopher J Ryerson
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Present Article ◽  
Interstitial Pneumonia ◽  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Interstitial Lung Diseases ◽  
Accurate Diagnosis ◽  
Management Approach ◽  
Chronic Hypersensitivity Pneumonitis

Chronic hypersensitivity pneumonitis (HP) arises from repeated exposure to causative antigens. Although HP can be challenging to diagnose, it is important to differentiate from idiopathic pulmonary fibrosis and idiopathic non-specific interstitial pneumonia. HP has a unique management approach and portends a unique prognosis. The present article summarizes the recent published literature on chronic HP and highlights the features that may be helpful in distinguishing it from other chronic interstitial lung diseases.

scholarly journals Real-life prevalence of progressive fibrosing interstitial lung diseases

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maureen Gagliardi ◽  
Damienne Vande Berg ◽  
Charles-Edouard Heylen ◽  
Sandra Koenig ◽  
Delphine Hoton ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Hypersensitivity Pneumonitis ◽  
Vital Capacity ◽  
Interobserver Agreement ◽  
Pulmonary Function Tests ◽  
Real Life ◽  
Interstitial Lung Diseases ◽  
Main Diagnosis ◽  
High Resolution Computed Tomography ◽  
Traction Bronchiectasis

AbstractThe concept of progressive fibrosing interstitial lung disease (PF-ILD) has recently emerged. However, real-life proportion of PF-ILDs outside IPF is still hard to evaluate. Therefore, we sought to estimate the proportion of PF-ILD in our ILD cohort. We also determined the proportion of ILD subtypes within PF-ILD and investigated factors associated with PF-ILDs. Finally, we quantified interobserver agreement between radiologists for the assessment of fibrosis. We reviewed the files of ILD patients discussed in multidisciplinary discussion between January 1st 2017 and December 31st 2019. Clinical data, pulmonary function tests (PFTs) and high-resolution computed tomography (HRCTs) were centrally reviewed. Fibrosis was defined as the presence of traction bronchiectasis, reticulations with/out honeycombing. Progression was defined as a relative forced vital capacity (FVC) decline of ≥ 10% in ≤ 24 months or 5% < FVC decline < 10% and progression of fibrosis on HRCT in ≤ 24 months. 464 consecutive ILD patients were included. 105 had a diagnosis of IPF (23%). Most frequent non-IPF ILD were connective tissue disease (CTD)-associated ILD (22%), hypersensitivity pneumonitis (13%), unclassifiable ILD (10%) and sarcoidosis (8%). Features of fibrosis were common (82% of CTD-ILD, 81% of HP, 95% of uILD). After review of HRCTs and PFTs, 68 patients (19% of non-IPF ILD) had a PF-ILD according to our criteria. Interobserver agreement for fibrosis between radiologists was excellent (Cohen’s kappa 0.86). The main diagnosis among PF-ILD were CTD-ILD (36%), HP (22%) and uILD (20%). PF-ILD patients were significantly older than non-F-ILD (P = 0.0005). PF-ILDs represent about 20% of ILDs outside IPF. This provides an estimation of the proportion of patients who might benefit from antifibrotics. Interobserver agreement between radiologists for the diagnosis of fibrotic ILD is excellent.

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