Acute Exacerbation of Chronic Hypersensitivity Pneumonitis: Incidence, Risk Factors and Outcome

2019 ◽  
Author(s):  
Y.J. Kim ◽  
J.W. Song ◽  
D.S. Kim
Keyword(s):  
Risk Factors ◽  
Acute Exacerbation ◽  
Hypersensitivity Pneumonitis ◽  
Incidence Risk ◽  
Chronic Hypersensitivity Pneumonitis

scholarly journals Acute exacerbation of fibrotic hypersensitivity pneumonitis: incidence and outcomes

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jieun Kang ◽  
Yeon Joo Kim ◽  
Jooae Choe ◽  
Eun Jin Chae ◽  
Jin Woo Song
Keyword(s):  
Risk Factors ◽  
Acute Exacerbation ◽  
Hypersensitivity Pneumonitis ◽  
Usual Interstitial Pneumonia ◽  
Lavage Fluid ◽  
Incidence Rates ◽  
Incidence Risk ◽  
Bilateral Lung ◽  
Mortality Hazard Ratio

Abstract Background Patients with fibrotic hypersensitivity pneumonitis (HP) show variable clinical courses, and some experience rapid deterioration (RD), including acute exacerbation (AE). However, little is known about AE in fibrotic HP. Here, we retrospectively examined the incidence, risk factors, and outcomes of AE in fibrotic HP. Methods The incidence rates of AE were calculated in 101 patients with biopsy-proven HP. AE was defined as the worsening of dyspnoea within 30 days, with new bilateral lung infiltration and no evidence of infection or other causes of dyspnoea. Results During follow-up (median: 30 months), 18 (17.8%) patients experienced AE. The 1, 3, and 5 year incidence rates of AE were 6.0, 13.6, and 22.8%, respectively. Lower diffusing capacity of the lung for carbon monoxide (DLCO) and a radiologic usual interstitial pneumonia (UIP)-like pattern were risk factors for AE. In-hospital mortality after AE was 44.4%. Median survival from diagnosis was significantly shorter in patients with AE (26.0 months) than in those with no-AE RD (55.0 months; p = 0.008) or no RD (not reached; p < 0.001). AE remained a significant predictor of all-cause mortality (hazard ratio, 8.641; 95% confidence interval, 3.388–22.040; p < 0.001) after adjustment for age, body mass index, lung function, lymphocyte levels in bronchoalveolar lavage fluid, and the presence of a UIP-like pattern. Conclusions AE was not uncommon among patients with fibrotic HP and significantly affected prognosis. A lower DLCO value and radiologic UIP-like pattern at diagnosis were associated with the development AE in patients with fibrotic HP.

scholarly journals An autopsy case of bird-related chronic hypersensitivity pneumonitis presenting with repeated acute exacerbation

2018 ◽  
Vol 24 ◽  
pp. 92-94
Author(s):  
Hironori Mikumo ◽  
Toyoshi Yanagihara ◽  
Naoki Hamada ◽  
Mikiko Hashisako ◽  
Kayo Ijichi ◽  
...  
Keyword(s):  
Acute Exacerbation ◽  
Hypersensitivity Pneumonitis ◽  
Autopsy Case ◽  
Chronic Hypersensitivity Pneumonitis

scholarly journals Chronic hypersensitivity pneumonitis is associated with an increased risk of venous thromboembolism: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Małgorzata Sobiecka ◽  
Monika Szturmowicz ◽  
Katarzyna Lewandowska ◽  
Agata Kowalik ◽  
Ewa Łyżwa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Venous Thromboembolism ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Hypersensitivity Pneumonitis ◽  
Significant Risk ◽  
Increased Risk ◽  
Chronic Hypersensitivity Pneumonitis ◽  
Incident Cases

Abstract Background Idiopathic pulmonary fibrosis (IPF) and chronic hypersensitivity pneumonitis share commonalities in pathogenesis shifting haemostasis balance towards the procoagulant and antifibrinolytic activity. Several studies have suggested an increased risk of venous thromboembolism in IPF. The association between venous thromboembolism and chronic hypersensitivity pneumonitis has not been studied yet. Methods A retrospective cohort study of IPF and chronic hypersensitivity pneumonitis patients diagnosed in single tertiary referral center between 2005 and 2018 was conducted. The incidence of symptomatic venous thromboembolism was evaluated. Risk factors for venous thromboembolism and survival among those with and without venous thromboembolism were assessed. Results A total of 411 (259 IPF and 152 chronic hypersensitivity) patients were included (mean age 66.7 ± 8.4 vs 51.0 ± 13.3 years, respectively). There were 12 (4.6%) incident cases of venous thromboembolism in IPF and 5 (3.3%) in chronic hypersensitivity pneumonitis cohort. The relative risk (RR) of venous thromboembolism in chronic hypersensitivity pneumonitis was not significantly different to that found in patients with IPF (7.1 vs 11.8/1000 person-years, RR 1.661 95% CI 0.545–6.019, respectively). The treatment with systemic steroids (OR 5.38; 95% CI 1.65–18.8, p = 0.006) and GAP stage 3 (OR 7.85; 95% CI 1.49–34.9; p = 0.037) were significant risk factors for venous thromboembolism in IPF. Arterial hypertension and pulmonary hypertension significantly increased risk of venous thromboembolism in chronic hypersensitivity pneumonitis. There were no significant differences in survival between patients with and without venous thromboembolism. Conclusions The patients with chronic hypersensitivity pneumonitis have a marked increase in the risk of venous thromboembolism, similar to the patients with IPF. Venous thromboembolism does not affect the survival of patients with IPF and chronic hypersensitivity pneumonitis.

scholarly journals Acute exacerbation of idiopathic pulmonary fibrosis: incidence, risk factors and outcome

2010 ◽  
Vol 37 (2) ◽  
pp. 356-363 ◽  
Author(s):  
J. W. Song ◽  
S.-B. Hong ◽  
C.-M. Lim ◽  
Y. Koh ◽  
D. S. Kim
Keyword(s):  
Risk Factors ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Acute Exacerbation ◽  
Incidence Risk
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