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Published in: Journal of Occupational Medicine and Toxicology 1/2015

Open Access 01-12-2015 | Methodology

Spotlight on the diagnosis of extrinsic allergic alveolitis (hypersensitivity pneumonitis)

Authors: Xaver Baur, Axel Fischer, Lygia T Budnik

Published in: Journal of Occupational Medicine and Toxicology | Issue 1/2015

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Abstract

Repeated inhalative exposures to antigenic material from a variety of sources, mainly from moulds, thermophilic Actinomycetes, and avians, respectively, can induce immune responses with the clinical picture of extrinsic allergic alveolitis (EAA) or hypersensitivity pneumonitis. Delays of years or even decades till the diagnosis is made are not uncommon; frequent misdiagnoses include allergic asthma, COPD, recurrent flue and other infections. We provide here the state of the art references, a detailed case description and recommend a current diagnostics schema.
Literature
1.
go back to reference Blatman KH, Grammer LC. Chapter 19: Hypersensitivity pneumonitis. Allergy Asthma Proc. 2012;33 Suppl 1:S64–6.CrossRefPubMed Blatman KH, Grammer LC. Chapter 19: Hypersensitivity pneumonitis. Allergy Asthma Proc. 2012;33 Suppl 1:S64–6.CrossRefPubMed
2.
go back to reference Lacasse Y, Girard M, Cormier Y. Recent advances in hypersensitivity pneumonitis. Chest. 2012;142:208–17.CrossRefPubMed Lacasse Y, Girard M, Cormier Y. Recent advances in hypersensitivity pneumonitis. Chest. 2012;142:208–17.CrossRefPubMed
3.
go back to reference Selman M, Pardo A, King Jr TE. Hypersensitivity pneumonitis: insights in diagnosis and pathobiology. Am J Respir Crit Care Med. 2012;186:314–24.CrossRefPubMed Selman M, Pardo A, King Jr TE. Hypersensitivity pneumonitis: insights in diagnosis and pathobiology. Am J Respir Crit Care Med. 2012;186:314–24.CrossRefPubMed
4.
go back to reference Baur X. Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanates. J Allergy Clin Immunol. 1995;95:1004–10.CrossRefPubMed Baur X. Hypersensitivity pneumonitis (extrinsic allergic alveolitis) induced by isocyanates. J Allergy Clin Immunol. 1995;95:1004–10.CrossRefPubMed
5.
go back to reference Robertson W, Robertson AS, Burge CB, Moore VC, Jaakkola MS, Dawkins PA, et al. Clinical investigation of an outbreak of alveolitis and asthma in a car engine manufacturing plant. Thorax. 2007;62:981–90.CrossRefPubMedCentralPubMed Robertson W, Robertson AS, Burge CB, Moore VC, Jaakkola MS, Dawkins PA, et al. Clinical investigation of an outbreak of alveolitis and asthma in a car engine manufacturing plant. Thorax. 2007;62:981–90.CrossRefPubMedCentralPubMed
6.
go back to reference Weiss W, Baur X. Antigens of powdered pearl-oyster shell causing hypersensitivity pneumonitis. Chest. 1987;91:146–8.CrossRefPubMed Weiss W, Baur X. Antigens of powdered pearl-oyster shell causing hypersensitivity pneumonitis. Chest. 1987;91:146–8.CrossRefPubMed
7.
go back to reference Baur X, Behr J, Dewair M, Ehret W, Fruhmann G, Vogelmeier C, et al. Humidifier lung and humidifier fever. Lung. 1988;166:113–24.CrossRefPubMed Baur X, Behr J, Dewair M, Ehret W, Fruhmann G, Vogelmeier C, et al. Humidifier lung and humidifier fever. Lung. 1988;166:113–24.CrossRefPubMed
8.
go back to reference Fox J, Anderson H, Moen T, Gruetzmacher G, Hanrahan L, Fink J. Metal working fluid-associated hypersensitivity pneumonitis: an outbreak investigation and case-control study. Am J Ind Med. 1999;35:58–67.CrossRefPubMed Fox J, Anderson H, Moen T, Gruetzmacher G, Hanrahan L, Fink J. Metal working fluid-associated hypersensitivity pneumonitis: an outbreak investigation and case-control study. Am J Ind Med. 1999;35:58–67.CrossRefPubMed
10.
go back to reference Rose C, King Jr TE. Controversies in hypersensitivity pneumonitis. Am Rev Respir Dis. 1992;145:1–2.CrossRefPubMed Rose C, King Jr TE. Controversies in hypersensitivity pneumonitis. Am Rev Respir Dis. 1992;145:1–2.CrossRefPubMed
11.
go back to reference Dalphin JC, Debieuvre D, Pernet D, Maheu MF, Polio JC, Toson B, et al. Prevalence and risk factors for chronic bronchitis and farmer's lung in French dairy farmers. Br J Ind Med. 1993;50:941–4.PubMedCentralPubMed Dalphin JC, Debieuvre D, Pernet D, Maheu MF, Polio JC, Toson B, et al. Prevalence and risk factors for chronic bronchitis and farmer's lung in French dairy farmers. Br J Ind Med. 1993;50:941–4.PubMedCentralPubMed
12.
go back to reference Lacasse Y, Selman M, Costabel U, Dalphin JC, Ando M, Morell F, et al. Clinical diagnosis of hypersensitivity pneumonitis. Am J Respir Crit Care Med. 2003;168:952–8.CrossRefPubMed Lacasse Y, Selman M, Costabel U, Dalphin JC, Ando M, Morell F, et al. Clinical diagnosis of hypersensitivity pneumonitis. Am J Respir Crit Care Med. 2003;168:952–8.CrossRefPubMed
13.
go back to reference Hanak V, Golbin JM, Hartman TE, Ryu JH. High-resolution CT findings of parenchymal fibrosis correlate with prognosis in hypersensitivity pneumonitis. Chest. 2008;134:133–8.CrossRefPubMed Hanak V, Golbin JM, Hartman TE, Ryu JH. High-resolution CT findings of parenchymal fibrosis correlate with prognosis in hypersensitivity pneumonitis. Chest. 2008;134:133–8.CrossRefPubMed
14.
go back to reference Munoz X, Sanchez-Ortiz M, Torres F, Villar A, Morell F, Cruz MJ. Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis. Eur Respir J. 2014;44:1658–65.CrossRefPubMed Munoz X, Sanchez-Ortiz M, Torres F, Villar A, Morell F, Cruz MJ. Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis. Eur Respir J. 2014;44:1658–65.CrossRefPubMed
15.
go back to reference Vandenplas O, Suojalehto H, Aasen TB, Baur X, Burge PS, De Blay F, et al. Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement. Eur Respir J. 2014;43:1573–87.CrossRefPubMed Vandenplas O, Suojalehto H, Aasen TB, Baur X, Burge PS, De Blay F, et al. Specific inhalation challenge in the diagnosis of occupational asthma: consensus statement. Eur Respir J. 2014;43:1573–87.CrossRefPubMed
16.
go back to reference Lima MS, Coletta EN, Ferreira RG, Jasinowodolinski D, Arakaki JS, Rodrigues SC, et al. Subacute and chronic hypersensitivity pneumonitis: histopathological patterns and survival. Respir Med. 2009;103:508–15.CrossRefPubMed Lima MS, Coletta EN, Ferreira RG, Jasinowodolinski D, Arakaki JS, Rodrigues SC, et al. Subacute and chronic hypersensitivity pneumonitis: histopathological patterns and survival. Respir Med. 2009;103:508–15.CrossRefPubMed
17.
go back to reference Takemura T, Akashi T, Ohtani Y, Inase N, Yoshizawa Y. Pathology of hypersensitivity pneumonitis. Curr Opin Pulm Med. 2008;14:440–54.CrossRefPubMed Takemura T, Akashi T, Ohtani Y, Inase N, Yoshizawa Y. Pathology of hypersensitivity pneumonitis. Curr Opin Pulm Med. 2008;14:440–54.CrossRefPubMed
18.
go back to reference Budnik LT, Preisser AM, Permentier H, Baur X. Is specific IgE antibody analysis feasible for the diagnosis of methylenediphenyl diisocyanate-induced occupational asthma? Int Arch Occup Environ Health. 2013;86:417–30.CrossRefPubMedCentralPubMed Budnik LT, Preisser AM, Permentier H, Baur X. Is specific IgE antibody analysis feasible for the diagnosis of methylenediphenyl diisocyanate-induced occupational asthma? Int Arch Occup Environ Health. 2013;86:417–30.CrossRefPubMedCentralPubMed
Metadata
Title
Spotlight on the diagnosis of extrinsic allergic alveolitis (hypersensitivity pneumonitis)
Authors
Xaver Baur
Axel Fischer
Lygia T Budnik
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Occupational Medicine and Toxicology / Issue 1/2015
Electronic ISSN: 1745-6673
DOI
https://doi.org/10.1186/s12995-015-0057-6

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