• J Allergy Clin Immunol Pract · Nov 2020

    Review

    Assessment and Management of Occupational Hypersensitivity Pneumonitis.

    • Iñigo Ojanguren, Vincent Ferraro, Julie Morisset, Xavier Muñoz, Jordan Fink, and María Jesús Cruz.
    • Servei de Pneumología, Hospital Universitari Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Servei de Pneumologia, Vall d´Hebron Institut de Recerca (VHIR), Barcelona, Spain; Instituto de Salud Carlos III, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain. Electronic address: iojanguren@vhebron.net.
    • J Allergy Clin Immunol Pract. 2020 Nov 1; 8 (10): 3295-3309.

    AbstractThe diagnosis and treatment of occupational hypersensitivity pneumonitis (OHP) remain complex and challenging in the absence of diagnostic gold standards or clinical guidelines. This review provides an update of the recent literature regarding the different presentations of OHP and the diagnostic yield and value of the diagnostic tests currently available, which include occupational and medical history, laboratory tests (serum-specific immunoglobulins, environmental sampling), imaging, bronchoalveolar lavage, transbronchial biopsy, transbronchial cryobiopsy, surgical lung biopsy, and specific inhalation challenges. These tools provide a precise differential diagnosis within the framework of interstitial lung diseases. However, among the chronic fibrotic forms, distinguishing OHP from sarcoidosis, nonspecific interstitial pneumonia and idiopathic pulmonary fibrosis remains a diagnostic challenge. Avoidance of exposure is pivotal for OHP management, whereas corticosteroids are fundamental in the pharmacological approach to this disease. In addition, studies describing the long-term benefits of immunosuppressive and antifibrotic agents have increased the use of these treatments in OHP.Copyright © 2020. Published by Elsevier Inc.

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