التهاب الرئة التحسسي غير التليفي مع التهاب نشط: عندما لا يُحسِّن تجنب التعرض وظائف الرئة

References

DOI: 10.1111/resp.14847

Moderate-to-high dose systemic corticosteroids would usually be considered for HP patients with features of inflammation (e.g., GGO on HRCT, BAL lymphocytosis, well-documented exposure with acute or sub-acute symptom onset).

Recently published international diagnostic guidelines recommend HP classification into fibrotic or nonfibrotic phenotypes based on the presence or absence of radiological and/or histopathological fibrosis, supported by the observation that pulmonary fibrosis conveys important prognostic and treatment implications.

For rapid onset pneumonitis with severe physiologic compromise, induction therapy may comprise of pulsed-dose intravenous methylprednisolone, followed by high-dose oral corticosteroids and often steroid-sparing agents (see below).

Following corticosteroid initiation, timely re-evaluation (e.g., between 6 and 12 weeks) is important to ensure improvement or stabilization in clinical symptoms and lung function, and to manage steroid-related side effects.