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• W4247120716 abstract "Acute hypersensitivity pneumonia is characterized by the onset of fever, malaise, dyspnea, and dry, hacking cough four to 12 hours following exposure to an appropriate antigen to which the individual has been sensitized. It is associated with leukocytosis (neutrophilia), infiltrates on chest roentgenogram, and spirometry suggestive of restrictive lung disease. Usually, serum precipitins for the offending antigen are present. A history of exposure is of primary importance in making the diagnosis, which can be confirmed by bronchoprovocation with the suspected antigen. The acute disease usually is self-limited but can be treated with corticosteroids. It need not progress to chronic disease, and thus lung biopsy or bronchoalveolar lavage rarely are indicated to help make the diagnosis. Chronic hypersensitivity pneumonia can present as slowly progressive breathlessness or less insidiously, following recurrent acute attacks. Findings consistent with interstitial fibrosis on chest roentgenogram and pulmonary function (restrictive pattern with a diminished diffusing capacity) are present. Serum precipitins and/or measures of delayed-type hypersensitivity usually are present, as is late or delayed-type skin test reactivity. Bronchoalveolar lavage reveals an increased number of T lymphocytes whereas lung biopsy demonstrates granulomas with lymphocytes early and fibrosis late in the disease. The chronic disease is only variably reversible with corticosteroids and removal of the antigen from the environment. The mechanisms behind the pathogenesis of both acute and chronic processes remain speculative and need not be the same. It seems most clear that in chronic hypersensitivity pneumonia, Type IV hypersensitivity is present. The acute disease can be explained either by local Type III reactions or by stimulation of alveolar macrophages. Suppressor activity may play a part in the development of symptoms in sensitized individuals." @default.
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• W4247120716 date "1981-05-01" @default.
• W4247120716 modified "2023-10-18" @default.
• W4247120716 title "Hypersensitivity pneumonia" @default.
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• W4247120716 doi "https://doi.org/10.1016/s0011-5029(81)80008-9" @default.
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