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Recent Advances in Chest Medicine |

Recent Advances in Hypersensitivity PneumonitisRecent Advances in Hypersensitivity Pneumonitis

Yves Lacasse, MD; Mélissa Girard, PhD; Yvon Cormier, MD
Author and Funding Information

From the Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), Québec, QC, Canada.

Correspondence to: Yves Lacasse, MD, Centre de Pneumologie, Institut Universitaire de Cardiologie et de Pneumologie de Québec (Hôpital Laval), 2725 Chemin Ste-Foy, Québec, QC, G1V 4G5, Canada; e-mail: Yves.Lacasse@med.ulaval.ca

Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(1):208-217. doi:10.1378/chest.11-2479
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Hypersensitivity pneumonitis (HP) is a pulmonary disease with symptoms of dyspnea and cough resulting from the inhalation of an allergen to which the subject has been previously sensitized. The diagnosis of HP most often relies on an array of nonspecific clinical symptoms and signs developed in an appropriate setting, with the demonstration of interstitial markings on chest radiographs, serum precipitating antibodies against offending antigens, a lymphocytic alveolitis on BAL, and/or a granulomatous reaction on lung biopsies. The current classification of HP in acute, subacute, and chronic phases is now challenged, and a set of clinical predictors has been proposed. Nonspecific interstitial pneumonitis, usual interstitial pneumonia, and bronchiolitis obliterans organizing pneumonia may be the sole histologic expression of the disease. Presumably, like in idiopathic interstitial pneumonia, acute exacerbations of chronic HP may occur without further exposure to the offending antigen. New offending antigens, such as mycobacteria causing hot tub lung and metalworking fluid HP, have recently been identified and have stimulated further research in HP.

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