Hypersensitivity Pneumonitis

  • Moisés Selman
  • Andrew Churg
Part of the Allergy Frontiers book series (ALLERGY, volume 4)

Hypersensitivity pneumonitis is a complex syndrome that develops after exposure to a large variety of environmental antigens, causing variable clinical symptoms often making diagnosis uncertain. Diagnosis of HP relies on a constellation of findings that include a suggestive environmental history, symptoms, physical findings, BAL lymphocytosis, imaging abnormalities, pulmonary function changes, and serum-specific antibodies. HRCT has improved diagnostic confidence. In the acute and subacute forms, removing the patient from the suspected environment often results in spontaneous amelioration of symptoms and this finding is a useful clue to the diagnosis. Inhalation challenge may be performed in selected patients in whom the causal relationship between antigen and lung disease has not been established. Finally, lung biopsy is recommended when the diagnosis is not apparent.

The pathogenesis of HP is intricate, and it is likely that both immune complexes and T-cell abnormalities participate in the development of the alveolitis, but in different phases and clinical forms of the disease. Importantly, HP occurs only in a few exposed individuals suggesting that some additional promoting factors (either genetic or environmental) play a role.


Interstitial Lung Disease Respir Crit Hypersensitivity Pneumonitis Usual Interstitial Pneumonia Idiopathic Interstitial Pneumonia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer 2009

Authors and Affiliations

  • Moisés Selman
    • 1
  • Andrew Churg
    • 2
  1. 1.Instituto Nacional de Enfermedades RespiratoriasMéxico
  2. 2.Department of PathologyUniversity of British ColumbiaVancouverCanada

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