رئة عشاق الطيور مع التهاب الرئة التحسسي الليفي على التصوير المقطعي عالي الدقة: عندما لا يُحسِّن تجنب التعرض وظائف الرئة

References

DOI: 10.1111/resp.14847

• Patients with HP may also display features of fibrosis, including reticulation, traction bronchiectasis and honeycombing (Figure 2B).
• 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.
• Despite this uncertainty, when both inflammatory and fibrotic clinical features are present, immunosuppressive therapy may still be reasonable, albeit with a lower expected magnitude of benefit than predominantly inflammatory lung disease.
• In some patients, upfront combination low-to-moderate dose corticosteroids and steroid-sparing therapy may be reasonable, particularly if unacceptable risk of steroid side effects prohibits higher dosing.
• For nonfibrotic HP, improvement in clinical parameters with therapy may be expected, whereas disease stabilization (or slowing of progression) may be more realistic goals in patients with predominantly fibrotic HP.