Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis

Viktor Hanak, Jason M. Golbin, Jay H Ryu

Research output: Contribution to journalArticle

120 Citations (Scopus)

Abstract

OBJECTIVE: To assess the current spectrum of causes and clinical features associated with hypersensitivity pneumonitis (HP). PATIENTS AND METHODS: We studied consecutive patients with HP diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1997, through December 31, 2002. Diagnostic criteria for HP included the following: (1) presence of respiratory symptoms, (2) radiologic evidence of diffuse lung disease, (3) known exposure or a positive serologic test result to an inciting antigen, and (4) no other identifiable cause for the lung disease. If there was no identifiable inciting antigen, 1 of the following 2 criteria was required: (1) lung biopsy specimen that demonstrated features of HP or (2) bronchoalveolar lavage lymphocytosis and high-resolution computed tomographic evidence of ground-glass opacities or centrilobular nodules bilaterally. RESULTS: The mean ± SD age of the 85 study patients was 53±14 years; 53 patients (62%) were women. Only 2 patients (2%) were current smokers. Chronic (≥24 months) respiratory symptoms were present in 66 patients (78%). Histopathologic confirmation was obtained in 64 patients (75%). The cause was identified in 64 patients (75%), and the most common causes were avlan antigens (34%) and Mycobacterium avium complex in hot tub water (21%). Farmer's lung disease accounted for 11% of cases, and an additional 9% were related to household mold exposure. The inciting antigen was not identifiable in 25% of patients. CONCLUSION: Most patients with HP seen at this tertiary care referral center in the Midwest region of the United States had chronic HP, and the most common causes were exposure to birds and exposure to hot tubs.

Original languageEnglish (US)
Pages (from-to)812-816
Number of pages5
JournalMayo Clinic Proceedings
Volume82
Issue number7
DOIs
StatePublished - 2007

Fingerprint

Extrinsic Allergic Alveolitis
Lung Diseases
Antigens
Tertiary Care Centers
Farmer's Lung
Mycobacterium avium Complex
Lymphocytosis
Serologic Tests
Bronchoalveolar Lavage
Birds
Glass
Fungi
Biopsy
Lung

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis. / Hanak, Viktor; Golbin, Jason M.; Ryu, Jay H.

In: Mayo Clinic Proceedings, Vol. 82, No. 7, 2007, p. 812-816.

Research output: Contribution to journalArticle

@article{589c7e3ffd494aa4b4fd238fff351832,
title = "Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis",
abstract = "OBJECTIVE: To assess the current spectrum of causes and clinical features associated with hypersensitivity pneumonitis (HP). PATIENTS AND METHODS: We studied consecutive patients with HP diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1997, through December 31, 2002. Diagnostic criteria for HP included the following: (1) presence of respiratory symptoms, (2) radiologic evidence of diffuse lung disease, (3) known exposure or a positive serologic test result to an inciting antigen, and (4) no other identifiable cause for the lung disease. If there was no identifiable inciting antigen, 1 of the following 2 criteria was required: (1) lung biopsy specimen that demonstrated features of HP or (2) bronchoalveolar lavage lymphocytosis and high-resolution computed tomographic evidence of ground-glass opacities or centrilobular nodules bilaterally. RESULTS: The mean ± SD age of the 85 study patients was 53±14 years; 53 patients (62{\%}) were women. Only 2 patients (2{\%}) were current smokers. Chronic (≥24 months) respiratory symptoms were present in 66 patients (78{\%}). Histopathologic confirmation was obtained in 64 patients (75{\%}). The cause was identified in 64 patients (75{\%}), and the most common causes were avlan antigens (34{\%}) and Mycobacterium avium complex in hot tub water (21{\%}). Farmer's lung disease accounted for 11{\%} of cases, and an additional 9{\%} were related to household mold exposure. The inciting antigen was not identifiable in 25{\%} of patients. CONCLUSION: Most patients with HP seen at this tertiary care referral center in the Midwest region of the United States had chronic HP, and the most common causes were exposure to birds and exposure to hot tubs.",
author = "Viktor Hanak and Golbin, {Jason M.} and Ryu, {Jay H}",
year = "2007",
doi = "10.4065/82.7.812",
language = "English (US)",
volume = "82",
pages = "812--816",
journal = "Mayo Clinic Proceedings",
issn = "0025-6196",
publisher = "Elsevier Science",
number = "7",

}

TY - JOUR

T1 - Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis

AU - Hanak, Viktor

AU - Golbin, Jason M.

AU - Ryu, Jay H

PY - 2007

Y1 - 2007

N2 - OBJECTIVE: To assess the current spectrum of causes and clinical features associated with hypersensitivity pneumonitis (HP). PATIENTS AND METHODS: We studied consecutive patients with HP diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1997, through December 31, 2002. Diagnostic criteria for HP included the following: (1) presence of respiratory symptoms, (2) radiologic evidence of diffuse lung disease, (3) known exposure or a positive serologic test result to an inciting antigen, and (4) no other identifiable cause for the lung disease. If there was no identifiable inciting antigen, 1 of the following 2 criteria was required: (1) lung biopsy specimen that demonstrated features of HP or (2) bronchoalveolar lavage lymphocytosis and high-resolution computed tomographic evidence of ground-glass opacities or centrilobular nodules bilaterally. RESULTS: The mean ± SD age of the 85 study patients was 53±14 years; 53 patients (62%) were women. Only 2 patients (2%) were current smokers. Chronic (≥24 months) respiratory symptoms were present in 66 patients (78%). Histopathologic confirmation was obtained in 64 patients (75%). The cause was identified in 64 patients (75%), and the most common causes were avlan antigens (34%) and Mycobacterium avium complex in hot tub water (21%). Farmer's lung disease accounted for 11% of cases, and an additional 9% were related to household mold exposure. The inciting antigen was not identifiable in 25% of patients. CONCLUSION: Most patients with HP seen at this tertiary care referral center in the Midwest region of the United States had chronic HP, and the most common causes were exposure to birds and exposure to hot tubs.

AB - OBJECTIVE: To assess the current spectrum of causes and clinical features associated with hypersensitivity pneumonitis (HP). PATIENTS AND METHODS: We studied consecutive patients with HP diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1997, through December 31, 2002. Diagnostic criteria for HP included the following: (1) presence of respiratory symptoms, (2) radiologic evidence of diffuse lung disease, (3) known exposure or a positive serologic test result to an inciting antigen, and (4) no other identifiable cause for the lung disease. If there was no identifiable inciting antigen, 1 of the following 2 criteria was required: (1) lung biopsy specimen that demonstrated features of HP or (2) bronchoalveolar lavage lymphocytosis and high-resolution computed tomographic evidence of ground-glass opacities or centrilobular nodules bilaterally. RESULTS: The mean ± SD age of the 85 study patients was 53±14 years; 53 patients (62%) were women. Only 2 patients (2%) were current smokers. Chronic (≥24 months) respiratory symptoms were present in 66 patients (78%). Histopathologic confirmation was obtained in 64 patients (75%). The cause was identified in 64 patients (75%), and the most common causes were avlan antigens (34%) and Mycobacterium avium complex in hot tub water (21%). Farmer's lung disease accounted for 11% of cases, and an additional 9% were related to household mold exposure. The inciting antigen was not identifiable in 25% of patients. CONCLUSION: Most patients with HP seen at this tertiary care referral center in the Midwest region of the United States had chronic HP, and the most common causes were exposure to birds and exposure to hot tubs.

UR - http://www.scopus.com/inward/record.url?scp=34347336319&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34347336319&partnerID=8YFLogxK

U2 - 10.4065/82.7.812

DO - 10.4065/82.7.812

M3 - Article

C2 - 17605960

AN - SCOPUS:34347336319

VL - 82

SP - 812

EP - 816

JO - Mayo Clinic Proceedings

JF - Mayo Clinic Proceedings

SN - 0025-6196

IS - 7

ER -