Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Québec, QC, Canada.
Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Québec, QC, Canada.
Chest. 2012 Jul;142(1):208-217. doi: 10.1378/chest.11-2479.
Hypersensitivity pneumonitis (HP) is a pulmonary disease with symptoms of dyspnea and cough resulting from the inhalation of an allergen to which the subject has been previously sensitized. The diagnosis of HP most often relies on an array of nonspecific clinical symptoms and signs developed in an appropriate setting, with the demonstration of interstitial markings on chest radiographs, serum precipitating antibodies against offending antigens, a lymphocytic alveolitis on BAL, and/or a granulomatous reaction on lung biopsies. The current classification of HP in acute, subacute, and chronic phases is now challenged, and a set of clinical predictors has been proposed. Nonspecific interstitial pneumonitis, usual interstitial pneumonia, and bronchiolitis obliterans organizing pneumonia may be the sole histologic expression of the disease. Presumably, like in idiopathic interstitial pneumonia, acute exacerbations of chronic HP may occur without further exposure to the offending antigen. New offending antigens, such as mycobacteria causing hot tub lung and metalworking fluid HP, have recently been identified and have stimulated further research in HP.
过敏性肺炎（HP）是一种肺部疾病，其症状为呼吸困难和咳嗽，是由于吸入过敏原引起的，而患者以前对此过敏原敏感。HP 的诊断通常依赖于在适当环境下出现的一系列非特异性临床症状和体征，胸部 X 线显示间质性标记，血清中针对致病抗原的沉淀抗体，BAL 中的淋巴细胞性肺泡炎，和/或肺活检中的肉芽肿反应。目前将 HP 分为急性、亚急性和慢性阶段，现在提出了一组临床预测因子。非特异性间质性肺炎、寻常性间质性肺炎和闭塞性细支气管炎机化性肺炎可能是该病的唯一组织学表现。推测与特发性间质性肺炎一样，慢性 HP 的急性加重可能在没有进一步接触致病抗原的情况下发生。最近已经确定了新的致病抗原，如引起热水浴缸肺和金属加工液 HP 的分枝杆菌，这激发了对 HP 的进一步研究。
