Department of Pediatric Pneumonology and Allergy, Medical University of Warsaw, Poland.
Department of Paediatrics, Paediatric and Social Nursing, Institute of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.
Ann Agric Environ Med. 2021 Jun 14;28(2):214-219. doi: 10.26444/aaem/118830. Epub 2020 May 8.
Hypersensitivity pneumonitis (HP) is one of the most common forms of interstitial lung disease in children. Due to its common association with occupational environment, it used to be considered an exclusively adult disease; however, hypersensitivity pneumonitis also affects the paediatric population, and is often associated with exposure to antigens in the home environment and with the pastime activities of children.
The aim of the study is to present the current state of knowledge on hypersensitivity pneumonitis in children with a focus on the peculiarities of diagnostic investigation and management of the disease in this age group. The study includes a case report of the disease in a child.
In children, the most common factors causing HP are avian and fungal antigens present in the home environment. Diagnosis is based on the co-occurrence of characteristic clinical presentation, radiographic and pulmonary function tests findings, and a history of exposure to a potential triggering antigen. The main strategy in the management of HP is to eliminate the trigger factor with the use of a systemic corticosteroids therapy in severe or advanced cases.
Due to the risk of irreversible changes in the respiratory tract, an early diagnosis is very important. A quick identification of the trigger factor and its elimination from the patient's environment makes it possible to apply a less aggressive treatment, and to improve the patient's prognosis. Unfortunately, due to its infrequent occurrence, hypersensitivity pneumonitis is often not taken into account in a differential diagnosis of respiratory diseases in children, which leads to a delayed diagnosis despite the characteristic clinical presentation of the disease.
过敏性肺炎（HP）是儿童中最常见的间质性肺疾病之一。由于其与职业环境的常见关联，过去它被认为是一种成人疾病；然而，过敏性肺炎也会影响儿科人群，并且通常与儿童在家庭环境中接触抗原以及儿童的业余活动有关。
本研究旨在介绍儿童过敏性肺炎的最新知识，重点介绍该年龄段疾病的诊断研究和管理特点。本研究包括一例儿童疾病的病例报告。
在儿童中，引起 HP 的最常见因素是存在于家庭环境中的禽和真菌抗原。诊断基于特征性临床表现、影像学和肺功能检查结果以及接触潜在触发抗原的病史同时发生。HP 管理的主要策略是在严重或晚期病例中使用全身性皮质类固醇治疗来消除触发因素。
由于呼吸道不可逆变化的风险，早期诊断非常重要。快速识别触发因素并将其从患者环境中消除，可采用侵袭性较小的治疗方法，并改善患者的预后。不幸的是，由于其罕见发生，过敏性肺炎在儿童呼吸道疾病的鉴别诊断中往往不被考虑，尽管该疾病具有特征性临床表现，但仍导致诊断延迟。
