Hypersensitivity pneumonitis, also known as extrinsic allergic alveolitis, is a complex and variegated disease that challenges respiratory clinicians, immunologists, radiologist and biologists involved in the care of patients with this condition. Considered to result from repeated exposure to a wide range of organic particles, hypersensitivity pneumonitis raises a number of questions. What determines which individuals will develop the disease among those exposed to frequently responsible antigens? Are clinicians missing the diagnosis of hypersensitivity pneumonitis in patients presenting with pulmonary fibrosis, and what are the most important features that should raise suspicion of this condition? What are the best diagnostic criteria? What are the best management options?
In this setting, there is a need for a comprehensive review covering a wide range of issues including those mentioned above. Hypersensitivity pneumonitis, edited by Om P. Sharma and written by 22 international expert authors, reviews both the scientific and clinical aspects of this heterogeneous and complex disease, providing a comprehensive and updated review of multiple aspects of the disease. Indeed, the book includes chapters on historical perspective, epidemiology, pathology, immunopathogenesis, imaging, differential diagnosis, the role of bronchoalveolar lavage and interventional radiology for diagnosis, lung function, genetics, treatment, and proteomics.
In addition, Hypersensitivity pneumonitis reviews presentations of the condition that are crucially important but are less well known by clinicians. For example, summer-type hypersensitivity pneumonitis, the most prevalent form in Japan, is related to the agent Trichosporon which is mainly found in old wooden houses. It generally occurs with acute disease and, less frequently, chronic disease, which may progress and has a poor outcome, similar to idiopathic pulmonary fibrosis. Another chapter is dedicated to newer syndromes of hypersensitivity pneumonitis, mostly due to recently identified agents or unusual conditions of exposure, including those encountered in: musicians playing wind instruments (saxophone); money counters using fresh banknotes; rose growers; citrus tree farmers; workers exposed to dry sausage mold while making salami; users of jet baths or steam baths (similar to hot tub lung); mushroom workers; inhalation of catechin-rich green tea extracts; and those exposed to phytase in cattle feed factories and to wheat flour, etc. The causes of farmer's lung and bird breeder's lung disease are also still expanding, with newer agents being identifi ed every year. Such situations are varied, and only expert reviews such as this book can update the list of exposures that one should have in mind when interacting with patients suspect to have hypersensitivity pneumonitis.
This book will serve as a highly valuable management guide, reference textbook and scientific review for clinicians and researchers seeking authoritative reviews. Sadly, Prof. Om Prakash Sharma, an internationally acclaimed specialist and respected physician, died while this book was at the final steps of editing. Hypersensitivity pneumonitis is one of many concise, clear, and informative books that Prof. Sharma has produced in his 50-year long career.
- ©ERS 2014
