Kouranos Vasileios, Jacob Joseph, Nicholson Andrew, Renzoni Elizabetta
Interstitial Lung Disease Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, Sydney Street, SW3 6NP London, UK.
Department of Radiology, Royal Brompton Hospital, London, UK.
J Clin Med. 2017 Jun 15;6(6):62. doi: 10.3390/jcm6060062.
The diagnosis of hypersensitivity pneumonitis (HP) relies on the clinical evaluation of a number of features, including a history of significant exposure to potentially causative antigens, physical examination, chest CT scan appearances, bronchoalveolar lavage lymphocytosis, and, in selected cases, histology. The presence of fibrosis is associated with higher morbidity and mortality. Differentiating fibrotic HP from the idiopathic interstitial pneumonias can be a challenge. Furthermore, even in the context of a clear diagnosis of fibrotic HP, the disease behaviour can parallel that of idiopathic pulmonary fibrosis in a subgroup, with inexorable progression despite treatment. We review the current knowledge on the diagnosis, management, and prognosis of HP with particular focus on the fibrotic phenotype.
过敏性肺炎（HP）的诊断依赖于对多种特征的临床评估，包括大量接触潜在致病抗原的病史、体格检查、胸部CT扫描表现、支气管肺泡灌洗淋巴细胞增多，以及在特定病例中的组织学检查。纤维化的存在与更高的发病率和死亡率相关。鉴别纤维化型HP与特发性间质性肺炎可能具有挑战性。此外，即使在明确诊断为纤维化型HP的情况下，该疾病在一部分患者中的表现可能与特发性肺纤维化相似，尽管接受治疗仍会不可阻挡地进展。我们回顾了目前关于HP的诊断、管理和预后的知识，特别关注纤维化表型。
