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What the allergist should know about hypersensitivity pneumonitis

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Hypersensitivity pneumonitis (HP) appears to be an underdiagnosed condition. It may masquerade as recurrent pneumonia, idiopathic pulmonary fibrosis, Haman-Rich disease, or interstitial pneumonitis. The nature of the disease depends on the immunologic reactivity of the host and the intensity and chronicity of exposure. Causative agents include thermophilic organisms, mold, animals, and chemicals. Typical symptoms of cough, shortness of breath, chills, and fever typically begin four to six hours after exposure with a remittance on avoidance. Chest x-ray demonstrates interstitial pneumonitis, and pulmonary function testing shows a restrictive component. A precipitating IgG antibody is the immunologic hallmark. The immunopathogenesis appears to represent a combination of type III and IV immune responses. Identifying the offending antigen is vital so that appropriate environmental precautions can be carried out.
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Keywords: HYPERSENSITIVITY; INTERSTITIAL; PNEUMONITIS

Document Type: Review Article

Affiliations: Division of Allergy and Immunology, Department of Internal Medicine, Saint Louis University School of Medicine, St. Louis, Missouri

Publication date: 01 January 2007

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  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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