Diagnosis, Clinical Course and Treatment of Hypersensitivity Pneumonitis

Jong Sun Park
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Abstract

Hypersensitivity pneumonitis (HP) is an inflammatory and fibrosing interstitial lung disease caused by inhaled antigens in susceptible individuals. Various environmental materials can serve as inciting agents of HP. Recent guidelines have defined typical radiologic and histopathologic findings of HP, classifying it into nonfibrotic and fibrotic HP categories, as this classification better correlates with clinical outcomes. Diagnosing HP poses challenges, necessitating multidisciplinary discussions based on clinical assessments and radiologic or histopathological features. The cornerstone of treatment lies in avoiding the causative antigen. Oral glucocorticoids serve as the initial treatment for symptomatic HP. Immunosuppressants may be employed in patients who do not respond to initial treatment, and antifibrotics could be considered for patients displaying progressive fibrosis. This review outlines the clinical features, diagnostic evaluation, and treatment of HP.
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过敏性肺炎的诊断、临床表现和治疗
超敏性肺炎(HP)是一种由易感人群吸入抗原引起的炎症性纤维化间质性肺病。各种环境物质都可能成为过敏性肺炎的诱发因素。最近的指南定义了 HP 的典型放射学和组织病理学结果,将其分为非纤维化和纤维化 HP 两类,因为这种分类与临床结果更相关。HP 的诊断具有挑战性,需要根据临床评估和放射学或组织病理学特征进行多学科讨论。治疗的基石在于避免使用致病抗原。口服糖皮质激素是治疗无症状 HP 的初始疗法。对初始治疗无效的患者可使用免疫抑制剂,显示进行性纤维化的患者可考虑使用抗纤维化药物。本综述概述了 HP 的临床特征、诊断评估和治疗方法。
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