Abstract
Hypersensitivity pneumonitis (HP) is a group of immunologically mediated lung diseases caused by the inhalation of environmental agents in susceptible individuals. Most HP patients are non-smokers and have been exposed to organic dusts from vegetable or animal products. Some HP cases are associated with exposures to relatively simple chemical compounds. HP may present as an acute, subacute, or chronic disease and may follow various clinical courses. The type of exposure is thought to be more important in the clinical outcome than the nature of the antigen. A diagnosis of HP is often considered on the basis of clinical history of exposure with resulting respiratory symptoms, but the definitive diagnosis requires a constellation of clinical, radiologic, laboratory, and pathologic findings. The characteristic histologic triad in HP includes bronchiolitis, interstitial lymphocytic infiltration, and granulomas; however, biopsy in HP cases may lack the diagnostic triad and manifest as nonspecific interstitial pneumonia (NSIP). Avoiding exposure to the offending antigen(s) is usually sufficient to resolve symptoms and physiological abnormalities. Pulmonary fibrosis and physiological abnormalities occurring in chronic HP may be irreversible. Steroid therapy is helpful for symptomatic relief, but probably does not affect the long-term prognosis. Type III and type IV hypersensitivity reactions are involved in the pathogenesis; alveolar macrophages and T cells (Th-1 type) play a central role in the immune responses after antigen exposure via their increased interaction and secretion of regulatory mediators.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 581-629 |
| Number of pages | 49 |
| Journal | Critical Reviews in Clinical Laboratory Sciences |
| Volume | 39 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2002 |
| Externally published | Yes |
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Keywords
- Extrinsic allergic alveolitis
- Farmer's lung
- Hot tub lung
- Hypersensitivity pneumonitis
- Metal worker's lung
- Nonspecific interstitial pneumonia (NSIP)
- Pigeon breeder's lung
ASJC Scopus subject areas
- Microbiology
- Hematology
- Immunology and Allergy
- Pathology and Forensic Medicine
- Radiology Nuclear Medicine and imaging
Cite this
Hypersensitivity pneumonitis. / Yi, Eunhee S.
In: Critical Reviews in Clinical Laboratory Sciences, Vol. 39, No. 6, 2002, p. 581-629.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Hypersensitivity pneumonitis
AU - Yi, Eunhee S.
PY - 2002
Y1 - 2002
N2 - Hypersensitivity pneumonitis (HP) is a group of immunologically mediated lung diseases caused by the inhalation of environmental agents in susceptible individuals. Most HP patients are non-smokers and have been exposed to organic dusts from vegetable or animal products. Some HP cases are associated with exposures to relatively simple chemical compounds. HP may present as an acute, subacute, or chronic disease and may follow various clinical courses. The type of exposure is thought to be more important in the clinical outcome than the nature of the antigen. A diagnosis of HP is often considered on the basis of clinical history of exposure with resulting respiratory symptoms, but the definitive diagnosis requires a constellation of clinical, radiologic, laboratory, and pathologic findings. The characteristic histologic triad in HP includes bronchiolitis, interstitial lymphocytic infiltration, and granulomas; however, biopsy in HP cases may lack the diagnostic triad and manifest as nonspecific interstitial pneumonia (NSIP). Avoiding exposure to the offending antigen(s) is usually sufficient to resolve symptoms and physiological abnormalities. Pulmonary fibrosis and physiological abnormalities occurring in chronic HP may be irreversible. Steroid therapy is helpful for symptomatic relief, but probably does not affect the long-term prognosis. Type III and type IV hypersensitivity reactions are involved in the pathogenesis; alveolar macrophages and T cells (Th-1 type) play a central role in the immune responses after antigen exposure via their increased interaction and secretion of regulatory mediators.
AB - Hypersensitivity pneumonitis (HP) is a group of immunologically mediated lung diseases caused by the inhalation of environmental agents in susceptible individuals. Most HP patients are non-smokers and have been exposed to organic dusts from vegetable or animal products. Some HP cases are associated with exposures to relatively simple chemical compounds. HP may present as an acute, subacute, or chronic disease and may follow various clinical courses. The type of exposure is thought to be more important in the clinical outcome than the nature of the antigen. A diagnosis of HP is often considered on the basis of clinical history of exposure with resulting respiratory symptoms, but the definitive diagnosis requires a constellation of clinical, radiologic, laboratory, and pathologic findings. The characteristic histologic triad in HP includes bronchiolitis, interstitial lymphocytic infiltration, and granulomas; however, biopsy in HP cases may lack the diagnostic triad and manifest as nonspecific interstitial pneumonia (NSIP). Avoiding exposure to the offending antigen(s) is usually sufficient to resolve symptoms and physiological abnormalities. Pulmonary fibrosis and physiological abnormalities occurring in chronic HP may be irreversible. Steroid therapy is helpful for symptomatic relief, but probably does not affect the long-term prognosis. Type III and type IV hypersensitivity reactions are involved in the pathogenesis; alveolar macrophages and T cells (Th-1 type) play a central role in the immune responses after antigen exposure via their increased interaction and secretion of regulatory mediators.
KW - Extrinsic allergic alveolitis
KW - Farmer's lung
KW - Hot tub lung
KW - Hypersensitivity pneumonitis
KW - Metal worker's lung
KW - Nonspecific interstitial pneumonia (NSIP)
KW - Pigeon breeder's lung
UR - http://www.scopus.com/inward/record.url?scp=0036445402&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0036445402&partnerID=8YFLogxK
U2 - 10.1080/10408360290795583
DO - 10.1080/10408360290795583
M3 - Article
C2 - 12484500
AN - SCOPUS:0036445402
VL - 39
SP - 581
EP - 629
JO - Critical Reviews in Clinical Laboratory Sciences
JF - Critical Reviews in Clinical Laboratory Sciences
SN - 1040-8363
IS - 6
ER -