open access

Vol 72, No 3-4 (2004)
ORIGINAL PAPERS
Published online: 2008-02-18
Submitted: 2013-02-22
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Hypersensitivity pneumonitis recognised by open lung biopsy in patients of Institute of Tuberculosis and Lung Diseases

Jacek Grudny, Elżbieta Wiatr, Renata Langfart, Piotr Rudziński, Tadeusz Orłowski, Iwona Bestry, Stefan Wesołowski, Kazimierz Roszkowski-Śliź
Pneumonol Alergol Pol 2004;72(3-4):78-84.

open access

Vol 72, No 3-4 (2004)
ORIGINAL PAPERS
Published online: 2008-02-18
Submitted: 2013-02-22

Abstract

Diagnosis of hypersensitivity pneumonitis (HP) is made on the basis of a combination of clinical features connected with the exposition to organic dusts, radiographic abnormalities, lung function tests and immunological tests. Open lung biopsy (OLB) and histological examination is not necessary and is indicated mainly in chronic and subacute form of HP. In the chronic form of HP symptoms often do not show a temporal relationship with antigen exposure and errors occur especially if specific questions are not asked about exposure to antigen if HP.
The aim of this paper was to analyse whether OLB was necessary in all patients in whom HP was recognised just after this procedure.
Material included 21 patients in whom microscopic examination suggested HP among 258 pts in whom OLB was performed in the period of 1998-2003 . There were 13 men and 8 women at the age of 18 to 65 years, mediana 42 years.
Results: We found 3 groups of pts. Group "+" included 9 exposed pts. They were asked and confirmed contact with birds, hay and 7 of them observed correlation between exposition and symptoms. The second Group "-" included 7 pts who were asked about exposition and who answered in the negative. In all of them HRCT scans suggested HP. Restriction was below 70% of VC in 3 pts. The third Group "0" included 5 pts who were not asked about exposition and correlation with symptoms. Two from them lived in the rural area.
Conclusions: Open lung biopsy was not necessary for 6 patients in Group "+", because then had enought symptoms to recognise HP. In 3 patients of Group "+" and in 5 of Group "0" OLB could be not necessary because specificanamnesis and additional examinations were not collected. OLB was necessary method for 7 patients in Group "-".

Abstract

Diagnosis of hypersensitivity pneumonitis (HP) is made on the basis of a combination of clinical features connected with the exposition to organic dusts, radiographic abnormalities, lung function tests and immunological tests. Open lung biopsy (OLB) and histological examination is not necessary and is indicated mainly in chronic and subacute form of HP. In the chronic form of HP symptoms often do not show a temporal relationship with antigen exposure and errors occur especially if specific questions are not asked about exposure to antigen if HP.
The aim of this paper was to analyse whether OLB was necessary in all patients in whom HP was recognised just after this procedure.
Material included 21 patients in whom microscopic examination suggested HP among 258 pts in whom OLB was performed in the period of 1998-2003 . There were 13 men and 8 women at the age of 18 to 65 years, mediana 42 years.
Results: We found 3 groups of pts. Group "+" included 9 exposed pts. They were asked and confirmed contact with birds, hay and 7 of them observed correlation between exposition and symptoms. The second Group "-" included 7 pts who were asked about exposition and who answered in the negative. In all of them HRCT scans suggested HP. Restriction was below 70% of VC in 3 pts. The third Group "0" included 5 pts who were not asked about exposition and correlation with symptoms. Two from them lived in the rural area.
Conclusions: Open lung biopsy was not necessary for 6 patients in Group "+", because then had enought symptoms to recognise HP. In 3 patients of Group "+" and in 5 of Group "0" OLB could be not necessary because specificanamnesis and additional examinations were not collected. OLB was necessary method for 7 patients in Group "-".
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Keywords

HP; open lung biopsy

About this article
Title

Hypersensitivity pneumonitis recognised by open lung biopsy in patients of Institute of Tuberculosis and Lung Diseases

Journal

Advances in Respiratory Medicine

Issue

Vol 72, No 3-4 (2004)

Pages

78-84

Published online

2008-02-18

Bibliographic record

Pneumonol Alergol Pol 2004;72(3-4):78-84.

Keywords

HP
open lung biopsy

Authors

Jacek Grudny
Elżbieta Wiatr
Renata Langfart
Piotr Rudziński
Tadeusz Orłowski
Iwona Bestry
Stefan Wesołowski
Kazimierz Roszkowski-Śliź

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