Hypersensitivity pneumonitis: application of a new diagnostic algorithm to a time series of the disease.
Expert Rev Respir Med
; 18(3-4): 237-243, 2024.
Article
de En
| MEDLINE
| ID: mdl-38775489
ABSTRACT
BACKGROUND:
The diagnostic criteria for Hypersensitivity pneumonitis (HP) have changed over time. Our aim is to apply a recent diagnostic algorithm to a historical series of patients diagnosed with HP to assess its distribution according to current diagnostic criteria and the diagnostic confidence achieved. RESEARCH DESIGN ANDMETHODS:
Application to each patient the algorithm criteria. The diagnosis was HP (≥90%), provisional high (70-89%) or low confidence (51-69%) or non-HP (unlikely) (≤50%); or HP, provisional or non-HP, if they had lung biopsy.RESULTS:
129 patients [mean age 64 ± 12 years; 79 (61.2%) women] were included of which 16 (12.4%) were diagnosed on the basis of high clinical suspicion. After applying the algorithm, 106 patients (82.2%) could be evaluated and 83 (78.3%) had a diagnosis of HP or high confidence. Lung biopsy was able to establish a diagnosis of certainty in another 21 patients and a provisional diagnosis in 9 more [total, 113 (87.6%)]. The 16 patients without strict diagnostic criteria for HP had a low confidence diagnosis. A total of 56 lung biopsies (64.4%) could have been avoided according to the new guidelines.CONCLUSIONS:
The application of this algorithm achieves a high diagnostic yield in HP, significantly reducing the number of lung biopsies required.Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Algorithmes
/
Alvéolite allergique extrinsèque
Limites:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Langue:
En
Journal:
Expert Rev Respir Med
Année:
2024
Type de document:
Article
Pays d'affiliation:
Espagne