hypersensitivity pneumonitis; extrinsic allergic alveolitis; pigeon breeder's lung; bird fancier's lung; farmer's lung; allergic pneumonitis

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Etiology

Epidemiology

Pathology

Clinical manifestations

Laboratory

Diagnostic procedures

Radiology

Differential diagnosis

* symptoms appearing 4-12 hours after exposure to mold make these other disorders unlikely

Management

  • removal of exposure to & avoidance of causative agent
    • resolution of symptoms in 48 hours
    • diagnostic & therapeutic (action of choice)
  • corticosteroids (high dose)
    • often used for patients with more severe symptoms &/or with evidence of fibrosis[3]
    • little effect on the natural course of the disease
    • prednisone maximum of 60 mg daily tapered slowly over several weeks[7]

More general terms

More specific terms

Additional terms

References

  1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
  2. Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 759-60
  3. 3.0 3.1 3.2 3.3 3.4 3.5 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15, 16, 17, 18, 19. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018, 2022.
    Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  4. 4.0 4.1 ARUP Consult: Hypersensitivity Pneumonitis - Extrinsic Allergic Alveolitis The Physician's Guide to Laboratory Test Selection & Interpretation https://www.arupconsult.com/content/hypersensitivity-pneumonitis
  5. Lacasse Y, Girard M, Cormier Y. Recent advances in hypersensitivity pneumonitis. Chest. 2012 Jul;142(1):208-17. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22796841
  6. Vasakova M, Morell F, Walsh S, Leslie K, Raghu G. Hypersensitivity Pneumonitis: Perspectives in Diagnosis and Management. Am J Respir Crit Care Med. 2017 Sep 15;196(6):680-689. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28598197
  7. 7.0 7.1 NEJM Knowledge Plus Question of the Week. April 6, 2021 https://knowledgeplus.nejm.org/question-of-week/270/
    Selman M, Buendia-Roldan I. Immunopathology, diagnosis, and management of hypersensitivity pneumonitis. Semin Respir Crit Care Med 2012 Sep 25; 33:543 PMID: https://www.ncbi.nlm.nih.gov/pubmed/23001807
    Riario Sforza GG, Marinou A. Hypersensitivity pneumonitis: a complex lung disease. Clin Mol Allergy 2017; 15:6. PMID: https://www.ncbi.nlm.nih.gov/pubmed/28286422 PMCID: PMC5339989 Free PMC article
  8. 8.0 8.1 NEJM Knowledge+ Allergy/Immunology
  9. Greenberger PA. Hypersensitivity pneumonitis: A fibrosing alveolitis produced by inhalation of diverse antigens. J Allergy Clin Immunol. 2019 Apr;143(4):1295-1301. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30448501 Review.
  10. No authors listed Hypersensitivity pneumonitis Nat Rev Dis Primers. 2020 Aug 6;6(1):66. PMID: https://www.ncbi.nlm.nih.gov/pubmed/32764556