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Semin Respir Crit Care Med 2016; 37(03): 395-405
DOI: 10.1055/s-0036-1580692
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Hypersensitivity Pneumonitis: Challenges in Diagnosis and Management, Avoiding Surgical Lung Biopsy

Ferran Morell
1   Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Catalonia, Spain
2   Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
,
Ana Villar
2   Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
3   Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
,
Iñigo Ojanguren
2   Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
3   Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
,
Xavier Muñoz
2   Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
3   Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
,
María-Jesús Cruz
2   Ciber de Enfermedades Respiratorias (CIBERES), Barcelona, Spain
3   Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Barcelona, Spain
› Author Affiliations
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Publication History

Publication Date:
27 May 2016 (online)

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Abstract

This review presents an update of the currently available information related to hypersensitivity pneumonitis, with a particular focus on the contribution of several techniques in the diagnosis of this condition. The methods discussed include proper elaboration of a complete medical history, targeted auscultation, detection of specific immunoglobulin G antibodies against the most common antigens causing this disease, skin tests, antigen-specific lymphocyte activation assays, bronchoalveolar lavage, and cryobiopsy. Special emphasis is placed on the relevant contribution of specific inhalation challenge (bronchial challenge test). Surgical lung biopsy is presented as the ultimate recourse, to be used when the diagnosis cannot be reached through the other methods covered.

Keywords

hypersensitivity pneumonitis - bronchoalveolar lavage - specific inhalation challenge - bronchial challenge test - precipitins - cryobiopsy - skin test
 

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