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Research Article: Multidisciplinary Discussion for Fibrotic Hypersensitivity Pneumonitis with a Positive Antigen Avoidance

Date Published: 2023-05-04

Abstract:
No diagnostic guidelines for fibrotic hypersensitivity pneumonitis (fHP) have been available until recently. The American Thoracic Society/Japanese Respiratory Society/Asociación Latinoamericana de Tórax (ATS/JRS/ALAT) Clinical Practice Guideline and the CHEST guidelines were published in and ., Both guidelines recommend multidisciplinary discussion (MDD) for the diagnosis of fHP based on exposure history, chest high-resolution computed tomography (HRCT), bronchoalveolar lavage fluid, and pathological findings. The procedures for diagnosing fHP are similar to the procedures for diagnosing idiopathic pulmonary fibrosis (IPF), including HRCT pattern, pathological pattern, and an MDD., However, many institutions face difficulty in conducting high-quality MDDs due to the absence of specialists who can treat interstitial lung disease (ILD). Clinical improvement with antigen avoidance was selected as one of the important diagnostic methods for an international modified Delphi survey, and antigen avoidance has long been methods used to diagnose fHP and estimate the inciting antigens., However, antigen avoidance test (AAT) was not given much weight in diagnostic HP guidelines. If MDD no longer had to be conducted in every patient of suspected fHP, more facilities would be able to diagnose fHP more easily. Therefore, we investigated whether MDD has additional prognostic power in patients with positive ATTs.

Introduction:
No diagnostic guidelines for fibrotic hypersensitivity pneumonitis (fHP) have been available until recently. The American Thoracic Society/Japanese Respiratory Society/Asociación Latinoamericana de Tórax (ATS/JRS/ALAT) Clinical Practice Guideline and the CHEST guidelines were published in and . , Both guidelines recommend multidisciplinary discussion (MDD) for the diagnosis of fHP based on exposure history, chest high-resolution computed tomography (HRCT), bronchoalveolar lavage fluid, and pathological findings.…

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