PMID- 24188571
OWN - NLM
STAT- MEDLINE
DCOM- 20150330
LR  - 20161125
IS  - 1752-699X (Electronic)
IS  - 1752-6981 (Linking)
VI  - 8
IP  - 3
DP  - 2014 Jul
TI  - Lung biopsy-proved hypersensitivity pneumonitis without known offending antigen: 
      characteristics and follow-up.
PG  - 297-304
LID - 10.1111/crj.12071 [doi]
AB  - INTRODUCTION: Hypersensitivity pneumonitis (HP) without known offending antigen 
      is hard to diagnose. OBJECTIVES: The purpose of this study was to identify and 
      analyze the clinical features of lung biopsy-proved HP. METHODS: A retrospective 
      cohort study was performed using a database from a 900-bed specialty hospital. 
      Twenty-eight patients with the diagnosis of HP through lung biopsy were enrolled. 
      Demographic data and clinical characteristics, radiologic characteristics, 
      serologic and pulmonary function results, histopathologic changes, treatment and 
      follow-up were analyzed. RESULTS: Of all the patients, serum interleukin-1beta, 
      C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), eosinophil 
      cationic protein and immunoglobulin E (IgE) were increased in over 50% patients, 
      but decreased significantly after corticosteroid therapy (P < 0.05). An initially 
      reduced diffusion lung capacity for carbon monoxide was noted in 92.9% patients, 
      while 39.3% patients had hypoxemia. Ground-glass opacities on the basis of 
      interlobular septa thickening were observed in 71.4% cases. Histopathological 
      findings demonstrated peribronchiolar lymphocytic infiltrates, poorly formed 
      non-caseating granulomas fibrosis in all acute and subacute HP patients' lungs. 
      Ninety-two percent of patients got improvement after corticosteroid therapy when 
      assessed by computer tomography scans and pulmonary function tests. CONCLUSIONS: 
      For suspected HP patients who without known offending antigens, earlier diagnosed 
      by lung biopsy and followed by corticosteroid therapy showed promising. It might 
      prevent the disease progression to lung fibrosis.
CI  - (c) 2013 John Wiley & Sons Ltd.
FAU - Xu, Jin-Fu
AU  - Xu JF
AD  - Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji 
      University School of Medicine, Shanghai, China.
FAU - Shen, Li
AU  - Shen L
FAU - Zhang, Yuan
AU  - Zhang Y
FAU - Zhang, Peng
AU  - Zhang P
FAU - Qu, Jie-Ming
AU  - Qu JM
FAU - Li, Hui-Ping
AU  - Li HP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140116
PL  - England
TA  - Clin Respir J
JT  - The clinical respiratory journal
JID - 101315570
RN  - 0 (Glucocorticoids)
RN  - 0 (Interleukin-1beta)
RN  - 37341-29-0 (Immunoglobulin E)
RN  - 7U1EE4V452 (Carbon Monoxide)
RN  - 9007-41-4 (C-Reactive Protein)
RN  - EC 3.1.27.- (Eosinophil Cationic Protein)
RN  - VB0R961HZT (Prednisone)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Alveolitis, Extrinsic Allergic/blood/*diagnosis/drug therapy
MH  - Biopsy
MH  - Blood Sedimentation
MH  - C-Reactive Protein/analysis
MH  - Carbon Monoxide/metabolism
MH  - Cohort Studies
MH  - Eosinophil Cationic Protein/blood
MH  - Female
MH  - Follow-Up Studies
MH  - Glucocorticoids/therapeutic use
MH  - Granuloma/pathology
MH  - Humans
MH  - Hypoxia/etiology
MH  - Immunoglobulin E/blood
MH  - Interleukin-1beta/blood
MH  - Lung/*pathology
MH  - Lymphocytes/pathology
MH  - Male
MH  - Middle Aged
MH  - Prednisone/therapeutic use
MH  - Pulmonary Fibrosis/pathology
MH  - Respiratory Function Tests
MH  - Retrospective Studies
MH  - Young Adult
OTO - NOTNLM
OT  - diagnosis
OT  - follow-up
OT  - hypersensitivity pneumonitis
OT  - lung biopsy
OT  - offending antigen
EDAT- 2013/11/06 06:00
MHDA- 2015/03/31 06:00
CRDT- 2013/11/06 06:00
PHST- 2013/08/03 00:00 [received]
PHST- 2013/10/16 00:00 [revised]
PHST- 2013/10/30 00:00 [accepted]
PHST- 2013/11/06 06:00 [entrez]
PHST- 2013/11/06 06:00 [pubmed]
PHST- 2015/03/31 06:00 [medline]
AID - 10.1111/crj.12071 [doi]
PST - ppublish
SO  - Clin Respir J. 2014 Jul;8(3):297-304. doi: 10.1111/crj.12071. Epub 2014 Jan 16.