• Hayley Barnes, Lauren Troy, Cathryn T Lee, Anne Sperling, Mary Strek, and Ian Glaspole.
• Central Clinical School, Monash University, Melbourne, VIC, Australia.
• Allergy. 2021 Jul 22.

AbstractHypersensitivity pneumonitis is an immune-mediated interstitial lung disease caused by an aberrant response to an inhaled exposure, which results in mostly T cell-mediated inflammation, granuloma formation, and fibrosis in some cases. HP is diagnosed by exposure identification, HRCT findings of ground-glass opacities, centrilobular nodules, and mosaic attenuation, with traction bronchiectasis and honeycombing in fibrotic cases. Additional testing including serum IgG testing for the presence of antigen exposure, bronchoalveolar lavage lymphocytosis, and lung biopsy demonstrating granulomas, inflammation, and fibrosis, increases the diagnostic confidence. Treatment for HP includes avoidance of the implicated exposure, immunosuppression, and anti-fibrotic therapy in select cases. This narrative review presents the recent literature in the understanding of the immunopathological mechanisms, diagnosis, and treatment of HP.© 2021 European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd.

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