Clinical features of chronic summer-type hypersensitivity pneumonitis and proposition of diagnostic criteria
| Autor: | Ryogo Kagami, Yasutaka Onishi, Nobuya Hirata, Kohei Miyake, Takanori Higashino, Tetsuji Kawamura |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty animal structures business.industry hemic and immune systems Trichosporon asahii medicine.disease Gastroenterology Elevated serum 03 medical and health sciences Idiopathic pulmonary fibrosis 0302 clinical medicine 030228 respiratory system Internal medicine Clinical diagnosis Chronic Disease medicine Etiology Biomarker (medicine) Summer-Type Hypersensitivity Pneumonitis Humans 030212 general & internal medicine business Hypersensitivity pneumonitis Alveolitis Extrinsic Allergic |
| Zdroj: | Respiratory investigation. 58(1) |
| ISSN: | 2212-5353 |
| Popis: | Background Trichosporon asahii (T. asahii) causes chronic summer-type hypersensitivity pneumonitis (C-SHP); however, little is known about the clinical features of this condition. We aimed to elucidate the clinical features of C-SHP and propose practical diagnostic criteria for C-SHP based on the presence of serum anti-T. asahii antibody (TaAb). Methods Patients diagnosed with C-SHP and idiopathic pulmonary fibrosis (IPF) between January 2010 and May 2017 were reviewed retrospectively. Clinical findings were compared between the two groups. Criteria for C-SHP were proposed on the basis of significant characteristics and applied to the development and validation cohorts. Results Thirty-one patients with C-SHP and 26 with TaAb-negative IPF were identified. C-SHP patients were more likely to live in wooden houses; their serum Krebs von den Lungen-6 (KL-6) and serum surfactant protein-D (SP-D) levels were higher than those of IPF patients. C-SHP patients were more likely to have subpleural consolidation, micronodules, and extensive ground-glass opacification on high-resolution computed tomography (HRCT). The following 3 items were considered to have diagnostic value: I) TaAb positivity; II) an HRCT pattern consistent with chronic hypersensitivity pneumonitis, including mosaic attenuation or micronodules; and III) elevated serum biomarker levels (KL-6 > 1500 U/mL or SP-D > 250 ng/mL). We defined cases satisfying I) and II) as “probable C-SHP” and those satisfying all 3 criteria as “confident clinical diagnosis of C-SHP”. The areas under the receiver-operating curve were 0.965 and 0.993 in the development and validation cohorts, respectively, which suggested that these criteria had good discriminative ability in clinical evaluations. Conclusions Clinical features could be useful for distinguishing C-SHP from IPF and other etiologies of ILDs. |
| Databáze: | OpenAIRE |
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