Treatment of Hypersensitivity Pneumonitis in Non-Fibrotic Disease
Hypersensitivity pneumonitis (HP) is classified into non-fibrotic and fibrotic forms. In non-fibrotic HP the lung has not undergone irreversible structural remodelling, which directly informs the approach to management.
Clinical Scenario
Patients with HP may be categorised as having non-fibrotic or fibrotic disease. In the non-fibrotic form — particularly where lung function is not severely impaired — a carefully staged approach is appropriate, and close monitoring may be sufficient once the source of exposure has been addressed.
Management Approach
The cornerstone of management in non-fibrotic HP is identifying and removing the causative exposure. Antigen-directed measures are the primary focus of the initial approach — the complete structured regimen is available in the full protocol.
References
DOI: 10.1183/16000617.0169-2021
- Patients with HP may be categorised as having non-fibrotic or fibrotic HP.
- In cases of non-fibrotic HP where the inciting antigen has been removed and lung function is not severely impaired, it may be appropriate not to initiate therapy but to ensure the patient is closely monitored.
- Antigen avoidance should be implemented wherever possible.
- Identification and elimination of the inciting antigen are critical to improving outcomes in patients with HP but can be difficult to achieve in practice.
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