Clinical Features and Prognosis in 21 Patients with Extrinsic Allergic Alveolitis

Wang, Ping; Xu, Zuojun; Xu, Weifeng; Shi, Jian; Tian, Xinlun; Ran, Feng; Zhu, Ying

doi:10.1016/s1001-9294(10)60002-8

Cited by 8 publications

(6 citation statements)

References 15 publications

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“…However, we have not observed family cluster phenomenon in our study. Aside from genetic factors, our results may indicate that environmental factors play an important role in the development of chDPLD.. EAA can be associated with exposure to a variety of finely dispersed environmental antigens [ 10 ], occupational exposures [ 11 ], and pet birds [ 12 ]. We have three cases of exposure-related ILD, two cases of EAA and one case of lipoid pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Application of Clinico-Radiologic-Pathologic Diagnosis of Diffuse Parenchymal Lung Diseases in Children in China

Chen

et al. 2015

PLoS ONE

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Diffuse parenchymal lung diseases in children (chDPLD) or interstitial lung diseases in children (chILD) represent a heterogeneous group of respiratory disorders that are mostly chronic and associated with high morbidity and mortality. However, the incidence of chDPLD is so low that most pediatricians lack sufficient knowledge of chDPLD, especially in China. Based on the clinico- radiologic- pathologic (CRP) diagnosis, we tried to describe (1) the characteristics of chDPLD and (2) the ratio of each constituent of chDPLD in China. Data were evaluated, including clinical, radiographic, and pathologic results from lung biopsies. We collected 25 cases of chDPLD, 18 boys and 7 girls with a median age of 6.0 years, from 16 hospitals in China. The most common manifestations included cough (n = 24), dyspnea (n = 21), and fever (n = 4). There were three cases of exposure-related interstitial lung disease (ILD), three cases of systemic disease-associated ILD, nineteen cases of alveolar structure disorder-associated ILD, and no cases of ILD specific to infancy. Non-specific interstitial pneumonia (n = 9) was the two largest groups. Conclusion: Non-specific interstitial pneumonia is the main categories of chDPLD in China. Lung biopsy is always a crucial step in the final diagnosis. However, clinical and imaging studies should be carefully evaluated for their value in indicating a specific chDPLD.

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Section: Discussionmentioning

confidence: 99%

Application of Clinico-Radiologic-Pathologic Diagnosis of Diffuse Parenchymal Lung Diseases in Children in China

Chen

et al. 2015

PLoS ONE

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“…The systematic review identified one randomized trial 63 and nine observational studies 41,61,[64][65][66][67][68][69][70] that evaluated HP patients' responses to medical therapy but not directly the diagnostic utility of clinical improvement with medical therapy (e-Tables 6a, 6b).…”

Section: Summary Of the Evidencementioning

confidence: 99%

“…68 A study of 18 patients with HP (one treated with antigen avoidance; 14 treated with antigen avoidance and prednisone, three treated with prednisone [1/3 also on cyclophosphamide]) reported that of 16 patients with chest imaging data, 8/16 (50%) showed HRCT normalization and 8/16 (50%) demonstrated improvement (no follow-up time specified). 69 Panel Discussion: The evidence from the studies included in this analysis is of very low-quality. The outcome data differ from the clinical question of interest as the diagnostic utility of medical treatment for HP was not directly assessed.…”

Section: Summary Of the Evidencementioning

confidence: 99%

Diagnosis and Evaluation of Hypersensitivity Pneumonitis

Pérez

Travis

Lynch

et al. 2021

Chest

159

132

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BACKGROUND:The purpose of this analysis is to provide evidence-based and consensusderived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice variability.STUDY DESIGN AND METHODS: Approved panelists developed key questions regarding the diagnosis of HP using the PICO (Population, Intervention, Comparator, Outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion, and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. The quality of the evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus. A diagnostic algorithm is provided, using supporting data from the recommendations where possible, along with expert consensus to help physicians gauge the probability of HP. RESULTS:The systematic review of the literature based on 14 PICO questions resulted in 14 key action statements: 12 evidence-based, graded recommendations and 2 ungraded consensusbased statements. All evidence was of very low quality.INTERPRETATION: Diagnosis of HP should employ a patient-centered approach and include a multidisciplinary assessment that incorporates the environmental and occupational exposure history and CT pattern to establish diagnostic confidence prior to considering BAL and/or lung biopsy. Criteria are presented to facilitate diagnosis of HP. Additional research is needed on the performance characteristics and generalizability of exposure assessment tools and traditional and new diagnostic tests in modifying clinical decision-making for HP, particularly among those with a provisional diagnosis.

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“…Clinical Improvement with Medical Therapy PICO Question 6: In patients with suspected HP, does clinical improvement with medical therapy support the diagnosis of HP? : The systematic review identified one randomized trial 33 and nine observational studies 16,31,[34][35][36][37][38][39][40] that evaluated the responses of patients with HP to medical therapy but not directly the diagnostic utility of clinical improvement with medical therapy (see e-Tables 6a and 6b from Fernández Pérez et al 10 ).…”

Section: Clinical History Takingmentioning

confidence: 99%

Executive Summary

Pérez

Travis

Lynch

et al. 2021

Chest

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BACKGROUND:The purpose of this analysis is to provide evidence-based and consensusderived guidance for clinicians to improve individual diagnostic decision-making for hypersensitivity pneumonitis (HP) and decrease diagnostic practice variability.STUDY DESIGN AND METHODS: Approved panelists developed key questions regarding the diagnosis of HP using the PICO (Population, Intervention, Comparator, and Outcome) format. MEDLINE (via PubMed) and the Cochrane Library were systematically searched for relevant literature, which was supplemented by manual searches. References were screened for inclusion and vetted evaluation tools were used to assess the quality of included studies, to extract data, and to grade the level of evidence supporting each recommendation or statement. The quality of the evidence was assessed using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) approach. Graded recommendations and ungraded consensus-based statements were drafted and voted on using a modified Delphi technique to achieve consensus. RESULTS:The systematic review of the literature based on 14 PICO questions resulted in 14 key action statements: 12 evidence-based, graded recommendations, and 2 ungraded consensus-based statements. All evidence was of very low quality.INTERPRETATION: Diagnosis of HP should employ a patient-centered approach and include a multidisciplinary assessment that incorporates the environmental and occupational exposure history and CT pattern to establish diagnostic confidence prior to considering BAL and/or lung biopsy. Additional research is needed on the performance characteristics and generalizability of exposure assessment tools and traditional and new diagnostic tests in modifying clinical decision-making for HP, particularly among those with a provisional diagnosis.

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Clinical Features and Prognosis in 21 Patients with Extrinsic Allergic Alveolitis

Cited by 8 publications

References 15 publications

Application of Clinico-Radiologic-Pathologic Diagnosis of Diffuse Parenchymal Lung Diseases in Children in China

Application of Clinico-Radiologic-Pathologic Diagnosis of Diffuse Parenchymal Lung Diseases in Children in China

Diagnosis and Evaluation of Hypersensitivity Pneumonitis

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