Hanak Viktor, Golbin Jason M, Ryu Jay H
Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN 55905, USA.
Mayo Clin Proc. 2007 Jul;82(7):812-6. doi: 10.4065/82.7.812.
To assess the current spectrum of causes and clinical features associated with hypersensitivity pneumonitis (HP).
We studied consecutive patients with HP diagnosed at the Mayo Clinic in Rochester, Minn, from January 1, 1997, through December 31, 2002. Diagnostic criteria for HP included the following: (1) presence of respiratory symptoms, (2) radiologic evidence of diffuse lung disease, (3) known exposure or a positive serologic test result to an inciting antigen, and (4) no other identifiable cause for the lung disease. If there was no identifiable inciting antigen, 1 of the following 2 criteria was required: (1) lung biopsy specimen that demonstrated features of HP or (2) bronchoalveolar lavage lymphocytosis and high-resolution computed tomographic evidence of ground-glass opacities or centrilobular nodules bilaterally.
The mean +/- SD age of the 85 study patients was 53 +/- 14 years; 53 patients (62%) were women. Only 2 patients (2%) were current smokers. Chronic (> or = 4 months) respiratory symptoms were present in 66 patients (78%). Histopathologic confirmation was obtained in 64 patients (75%). The cause was identified in 64 patients (75%), and the most common causes were avian antigens (34%) and Mycobacterium avium complex in hot tub water (21%). Farmer's lung disease accounted for 11% of cases, and an additional 9% were related to household mold exposure. The inciting antigen was not identifiable in 25% of patients.
Most patients with HP seen at this tertiary care referral center in the Midwest region of the United States had chronic HP, and the most common causes were exposure to birds and exposure to hot tubs.
评估与过敏性肺炎（HP）相关的当前病因谱和临床特征。
我们研究了1997年1月1日至2002年12月31日期间在明尼苏达州罗切斯特市梅奥诊所确诊的连续性HP患者。HP的诊断标准包括：（1）存在呼吸道症状；（2）弥漫性肺部疾病的放射学证据；（3）已知接触某种激发抗原或针对该激发抗原的血清学检测结果呈阳性；（4）无其他可识别的肺部疾病病因。如果没有可识别的激发抗原，则需要满足以下两项标准中的一项：（1）肺活检标本显示HP的特征；（2）支气管肺泡灌洗淋巴细胞增多以及双侧磨玻璃样阴影或小叶中心结节的高分辨率计算机断层扫描证据。
85例研究患者的平均年龄±标准差为53±14岁；53例患者（62%）为女性。仅有2例患者（2%）为当前吸烟者。66例患者（78%）存在慢性（≥4个月）呼吸道症状。64例患者（75%）获得了组织病理学确诊。64例患者（75%）明确了病因，最常见的病因是禽类抗原（34%）和热水浴缸中的鸟分枝杆菌复合体（21%）。农民肺疾病占病例的11%，另外9%与家庭霉菌接触有关。25%的患者无法识别激发抗原。
在美国中西部地区这家三级医疗转诊中心就诊的大多数HP患者患有慢性HP，最常见的病因是接触鸟类和接触热水浴缸。
