RISK FACTORS FOR ACUTE EXACERBATIONS OF HYPERSENSITIVITY PNEUMONITIS

Abstract

TYPE: Abstract TOPIC: Diffuse Lung Disease PURPOSE: Acute exacerbations (AE) of Interstitial Lung Diseases are associated with bad outcomes. In Hypersensitivity Pneumonitis (HP), there is little evidence regarding factors associated with their development. METHODS: A retrospective analysis of 119 HP patients followed at our center between 2012-2017 was performed. AE was defined as worsening of dyspnea within a 30-day period, with new bilateral lung infiltration and no evidence of other causes of dyspnea, leading to hospitalization. RESULTS: A total of 15 (13.0%) patients developed AE of HP in a median 36 months follow-up. Patients with AE were younger (59.8 ± 10.0 years) than those without AE (69.2 ± 11.3years), p<0.01. Regarding lung function, patients with AE had lower FVC % (69.8 vs 85.7, p=0.024) and lower FEV1% (74.9 vs 90.3, p=0.032). Lower age, FVC%, FEV1% and exposure to mold/humidity were independent risk factors for development of AE in an univariate analysis (p<0.05). Patients who reported exposure to humidity/mold had a higher rate of AE (23.5% vs 9.0%, p=0.041). Exposure to humidity/mold remained a significant risk factor for AE even after adjusting for FVC%, FEV1% and age (OR 3.79, p=0.037). A total of 6 patients died during the exacerbation (40.0%). CONCLUSIONS: A worst lung function, lower age, and a patient report of exposure to humidity or molds were factors associated with the development of AE. This entity is associated with high in-hospital mortality. CLINICAL IMPLICATIONS: A better recognition of risk factors may enable strategies for early recognition and management of AE. An exposure etiologic factor identification can elucidate on strategies to avoid exacerbations. DISCLOSURE: Nothing to declare. KEYWORD: Hypersensitivity Pneumonitis