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Original Paper

Classification of Hypersensitivity Pneumonitis

A Hypothesis

Lacasse Y.a · Selman M.c · Costabel U.d · Dalphin J.-C.e · Morell F.f · Erkinjuntti-Pekkanen R.g · Mueller N.L.b · Colby T.V.h · Schuyler M.i · Jomphe V.a · Cormier Y.a

Author affiliations

aHôpital Laval, Université Laval, Québec, Qué., bUniversity of British Columbia, Vancouver, B.C., Canada; cInstituto Nacional de Enfermedades Respiratorias, México, México; dRuhrlandklinik, Essen, Germany; eCentre Hospitalier Universitaire de Besançon, Besançon, France; fHospital Universitari Vall d’Hebron UAB, Barcelona, Spain; gKuopio University Hospital, Kuopio, Finland; hMayo Clinic Scottsdale, Scottsdale, Ariz., iUniversity of New Mexico School of Medicine, Albuquerque, N. Mex., USA

Related Articles for ""

Int Arch Allergy Immunol 2009;149:161–166

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 11, 2008
Accepted: September 30, 2008
Published online: January 06, 2009
Issue release date: May 2009

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 5

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: https://www.karger.com/IAA

Abstract

Background: Regardless of the causative antigen, hypersensitivity pneumonitis (HP) is usually classified as ‘acute’, ‘subacute’ or ‘chronic’. Considerable confusion still surrounds this classification because there are no widely accepted criteria to distinguish the various stages. The objective of this study wasto determine whether the current classification of HP truly reflects categories of patients with distinct clinical features. Methods: Data obtained from a large prospective multicenter cohort study (the HP Study) were used to divide a cohort of patients with HP into a limited number of categories (clusters) with maximally differing clinical patterns, without prejudgment. The results of this cluster analysis were compared with the current classification of HP (acute, subacute or chronic). Results: 168 patients were included in the analysis. A 2-cluster solution best fitted the data. Patients in cluster 1 (41 patients) had more recurrent systemic symptoms (chills and body aches) and normal chest radiographs than those in cluster 2 (127 patients) who showed significantly more clubbing, hypoxemia, restrictive patterns on pulmonary function tests and fibrosis on high-resolution computed tomography (HRCT). All p values were <0.0001, using Fisher’s exact test. Nodular opacities were seen on HRCT as often in cluster 1 as in cluster 2. There was considerable disagreement between the current classification of HP and the results of our analysis. Conclusion: The current classification of acute, subacute and chronic HP is not supported by our analysis. Subacute HP is particularly difficult to define.

© 2009 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: June 11, 2008
Accepted: September 30, 2008
Published online: January 06, 2009
Issue release date: May 2009

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 5

ISSN: 1018-2438 (Print)
eISSN: 1423-0097 (Online)

For additional information: https://www.karger.com/IAA


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