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Chronic Hypersensitivity Pneumonitis

Fibrotic interstitial lung disease driven by chronic exposure to inhaled organic antigens.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Chronic Hypersensitivity Pneumonitis?

Chronic (fibrotic) hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease resulting from prolonged inhalation of organic antigens (avian proteins, fungi, mycobacteria, isocyanates) in genetically susceptible patients.

Clinical features include progressive dyspnea, cough, weight loss, restrictive lung physiology and characteristic HRCT findings of mosaic attenuation, three-density sign, centrilobular nodules and upper-lobe predominant fibrosis.

Diagnosis is multidisciplinary using exposure history, specific IgG antibodies, BAL lymphocytosis, HRCT, and surgical or transbronchial cryobiopsy when needed; treatment combines complete antigen avoidance, corticosteroids, steroid-sparing agents (mycophenolate, azathioprine) and antifibrotic drugs (nintedanib) in progressive fibrotic disease.

Symptoms

Progressive exertional dyspnea
Chronic cough
Weight loss and fatigue
Velcro inspiratory crackles
Clubbing in late disease
Worsening symptoms after antigen exposure
Reduced exercise capacity

Risk Factors

Bird breeding or contact (pigeons, parakeets)
Mold exposure (water-damaged buildings, hot tubs)
Farming and hay storage
Use of humidifiers or fountains
Occupational chemical exposure
Genetic susceptibility (telomere genes, MUC5B)
Smoking can paradoxically modify presentation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Progressive dyspnea with relevant exposure history
  • Persistent cough not responding to bronchodilators
  • Recurrent symptoms after returning to a specific environment
  • Family history of pulmonary fibrosis
  • Imaging suggestive of HP
  • Need for multidisciplinary ILD evaluation
  • Worsening despite antigen avoidance

Treatment Methods

01
Identification and complete avoidance of causative antigen
02
High-resolution CT and BAL lymphocyte analysis
03
Specific serum IgG to suspected antigens
04
Corticosteroids in active inflammatory disease
05
Mycophenolate mofetil or azathioprine as steroid-sparing agents
06
Nintedanib for progressive fibrotic HP
07
Pulmonary rehabilitation, oxygen therapy and lung transplantation in end-stage disease

Which Department to Visit?

You can visit our Göğüs Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.