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Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis
Viktor Hanak1, Jason M Golbin, Jay H Ryu
1Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clinic Proceedings
|July 4, 2007
Summary
Hypersensitivity pneumonitis (HP) is often chronic, with avian antigens and hot tub exposure being the most frequent causes. This study assessed the spectrum of causes and clinical features of HP.
Area of Science:
- Pulmonology
- Immunology
- Environmental Medicine
Background:
- Hypersensitivity pneumonitis (HP) is a complex immune-mediated lung disease.
- Identifying the spectrum of causes and clinical presentations is crucial for diagnosis and management.
Purpose of the Study:
- To assess the current spectrum of causes and clinical features associated with hypersensitivity pneumonitis (HP).
Main Methods:
- Retrospective study of 85 patients diagnosed with HP at Mayo Clinic from 1997-2002.
- Diagnostic criteria included respiratory symptoms, radiologic evidence, known antigen exposure or serologic tests, and exclusion of other causes.
- Histopathologic confirmation or bronchoalveolar lavage findings were used when antigen was not identified.
Main Results:
- The majority of patients (78%) presented with chronic respiratory symptoms.
- Identified causes included avian antigens (34%), Mycobacterium avium complex from hot tubs (21%), Farmer's lung (11%), and household mold (9%).
- The inciting antigen remained unidentified in 25% of cases.
Conclusions:
- Most patients with HP at this referral center experienced chronic disease.
- Common causes were exposure to birds and contaminated hot tub water.
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