Hypersensitivity Pneumonitis High-resolution Computed Tomography Findings, and Their Correlation with the Etiology and the Disease Duration.

Farzaneh Shobeirian,Abtin Doroudinia,Payam Mehrian

doi:10.14712/23362936.2020.12

Abstract

Hypersensitivity pneumonitis (HP) is an immune-mediated diffuse parenchymal lung disease induced by inhaled antigens. High-resolution computed tomography (HRCT) is widely used in the diagnosis and follow-up of patients and determining the progression and prognosis of the disease. In this retrospective study, 45 consecutive patients with the final diagnosis of HP, seen at a large tertiary care center during a period of 4 years, were included and their HRCT findings were evaluated. The most common HRCT findings were ground glass opacity and reticulation. Some HRCT patterns were detected more severely in bird fanciers in comparison with other etiologies. There is no "gold standard" for the diagnosis of HP. HRCT findings play an important role in hypersensitivity pneumonitis diagnosis and CT scan also help to define the severity of hypersensitivity pneumonitis injuries. In our study, reticulation and ground glass opacity were the most common findings in HRCT of patients with HP. We also find that patients with avian contacts had a significantly higher rate of fibrosis.

Highlights

Hypersensitivity pneumonitis (HP), known as extrinsic allergic alveolitis, is an immune-mediated diffuse parenchymal lung disease, induced by repeated inhalation of an antigen in a sensitized host (Hanak et al, 2007; Mooney et al, 2013)
The radiographic chest X-ray has always been important in diagnosis, the recently developed high resolution computed tomography (HRCT) has become a highly informative diagnostic parameter, which is more sensitive and the normal High-resolution computed tomography (HRCT) is a strong evidence against the diagnosis of active HP (Cormier et al, 2000; Franks and Galvin, 2010)
HRCT findings are an important part of hypersensitivity pneumonitis diagnosis

Summary

Introduction

Hypersensitivity pneumonitis (HP), known as extrinsic allergic alveolitis, is an immune-mediated diffuse parenchymal lung disease, induced by repeated inhalation of an antigen in a sensitized host (Hanak et al, 2007; Mooney et al, 2013). Centrilobular nodules are mostly detected in subacute form They can be associated with fibrosis in chronic forms which mainly have ground glass opacity. Consolidation is not the main abnormality in HP HRCT and may represent areas of organizing pneumonia or superimposed infections or acute exacerbation (Adler et al, 1992; Cormier et al, 2000; Silva et al, 2007; Rosenman, 2009; Franks and Galvin, 2010; Akira and Suganuma, 2014; Lynch, 2016; Pereira et al, 2016; Vasakova et al, 2017; Dias et al, 2018)

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