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Fibrotic Hypersensitivity Pneumonitis: Key Issues in Diagnosis and Management

1
Interstitial Lung Disease Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College, Sydney Street, SW3 6NP London, UK
2
Department of Radiology, Royal Brompton Hospital, London, UK
3
Department of Histopathology, Royal Brompton Hospital, and National Heart and Lung Institute, Imperial College, London, UK
*
Author to whom correspondence should be addressed.
Academic Editor: David Barnes
J. Clin. Med. 2017, 6(6), 62; https://doi.org/10.3390/jcm6060062
Received: 2 May 2017 / Revised: 7 June 2017 / Accepted: 8 June 2017 / Published: 15 June 2017
(This article belongs to the Special Issue Chronic Respiratory Diseases)
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. View Full-Text
Keywords: fibrotic hypersensitivity pneumonitis; idiopathic pulmonary fibrosis; diagnosis; prognosis fibrotic hypersensitivity pneumonitis; idiopathic pulmonary fibrosis; diagnosis; prognosis
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Kouranos, V.; Jacob, J.; Nicholson, A.; Renzoni, E. Fibrotic Hypersensitivity Pneumonitis: Key Issues in Diagnosis and Management. J. Clin. Med. 2017, 6, 62.

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