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[过敏性肺炎的诊断:2020年临床实践指南]

[Diagnosis of Hypersensitivity Pneumonitis: 2020 Clinical Practice Guideline].

作者信息

Park Soojung, Oh Yu-Whan, Kang Eun-Young, Yong Hwan Seok, Kim Cherry, Lee Ki Yeol, Hwang Sung Ho

出版信息

Taehan Yongsang Uihakhoe Chi. 2021 Jul;82(4):817-825. doi: 10.3348/jksr.2021.0075. Epub 2021 Jul 26.

Abstract

Hypersensitivity pneumonitis (HP) is an interstitial lung disease (ILD) characterized by an inhaled inciting antigen that leads to the inflammation of the lung parenchyma and small airway with immunologic reactions. Over the last decades, the most effective therapeutic option for HP has been limited to antigen avoidance. The differential diagnosis of HP from other ILDs is the beginning of treatment as well as diagnosis. However, the presence of several overlapping clinical and radiologic features makes differentiating HP from other ILDs particularly challenging. In 2020, a multidisciplinary committee of experts from the American Thoracic Society, Japanese Respiratory Society, and Asociación Latinoamericana del Tórax suggested a new clinical practice guideline classifying HP into nonfibrotic and fibrotic phenotypes on the basis of chest high-resolution CT (HRCT) findings. Therefore, we introduced a new diagnostic algorithm based on chest HRCT in the clinical practice guideline for the diagnosis of HP.

摘要

过敏性肺炎(HP)是一种间质性肺疾病(ILD),其特征是吸入刺激性抗原后引发肺实质和小气道炎症,并伴有免疫反应。在过去几十年中,HP最有效的治疗选择一直局限于避免接触抗原。将HP与其他ILD进行鉴别诊断是治疗和诊断的起点。然而,由于存在一些重叠的临床和放射学特征,将HP与其他ILD区分开来极具挑战性。2020年,美国胸科学会、日本呼吸学会和拉丁美洲胸科学会的多学科专家委员会建议了一项新的临床实践指南,根据胸部高分辨率CT(HRCT)结果将HP分为非纤维化和纤维化表型。因此,我们在HP诊断的临床实践指南中引入了基于胸部HRCT的新诊断算法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/970b/9514409/e717ba9690f4/jksr-82-817-g001.jpg

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Diagnosis of Hypersensitivity Pneumonitis in Adults. An Official ATS/JRS/ALAT Clinical Practice Guideline.
Am J Respir Crit Care Med. 2020 Aug 1;202(3):e36-e69. doi: 10.1164/rccm.202005-2032ST.
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