Hypersensitivity pneumonitis: application of a new diagnostic algorithm to a time series of the disease.

Autor:	Casal A; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Suárez-Antelo J; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Riveiro V; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Ferreiro L; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain., Rodríguez-García C; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., de Alegría AM; Radiology Unit, University Clinical Hospital of Santiago de Compostela, Spain., Antúnez JR; Pathological Anatomy Unit, University Clinical Hospital of Santiago de Compostela, Spain., Tobes ME; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Otero B; Nursing Service, Esteve Teijin, Santiago de Compostela, Spain., Rodríguez-Núñez N; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain., Álvarez-Dobaño JM; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain., Vargas-Osorio K; Pathological Anatomy Unit, University Clinical Hospital of Santiago de Compostela, Spain., Gude F; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.; Clinical Epidemiology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de compostela, Spain., Valdés L; Pulmonology Unit, University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain.; Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.; Department of Medicine, Faculty of Medicine of the University of Santiago de Compostela, Spain.
Jazyk:	angličtina
Zdroj:	Expert review of respiratory medicine [Expert Rev Respir Med] 2024 Mar-Apr; Vol. 18 (3-4), pp. 237-243. Date of Electronic Publication: 2024 May 30.
DOI:	10.1080/17476348.2024.2358939
Abstrakt:	Background: The diagnostic criteria for Hypersensitivity pneumonitis (HP) have changed over time. Our aim is to apply a recent diagnostic algorithm to a historical series of patients diagnosed with HP to assess its distribution according to current diagnostic criteria and the diagnostic confidence achieved. Research Design and Methods: Application to each patient the algorithm criteria. The diagnosis was HP (≥90%), provisional high (70-89%) or low confidence (51-69%) or non-HP (unlikely) (≤50%); or HP, provisional or non-HP, if they had lung biopsy. Results: 129 patients [mean age 64 ± 12 years; 79 (61.2%) women] were included of which 16 (12.4%) were diagnosed on the basis of high clinical suspicion. After applying the algorithm, 106 patients (82.2%) could be evaluated and 83 (78.3%) had a diagnosis of HP or high confidence. Lung biopsy was able to establish a diagnosis of certainty in another 21 patients and a provisional diagnosis in 9 more [total, 113 (87.6%)]. The 16 patients without strict diagnostic criteria for HP had a low confidence diagnosis. A total of 56 lung biopsies (64.4%) could have been avoided according to the new guidelines. Conclusions: The application of this algorithm achieves a high diagnostic yield in HP, significantly reducing the number of lung biopsies required.
Databáze:	MEDLINE
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