Figures
- FIGURE 1
Chest high-resolution computed tomography (HRCT) of a–c) acute hypersensitivity pneumonitis and d–f) chronic hypersensitivity pneumonitis. Chest HRCT of acute hypersensitivity pneumonitis shows bilateral ground-glass densities with centrilobular micronodular accentuation and minor consolidation. Chest HRCT of chronic hypersensitivity pneumonitis shows bilateral reticular shadowing, traction bronchiectasis and minor mosaic perfusion along with some micronodules.
- FIGURE 2
Diagnostic algorithm of granulomatous lung diseases. OP: organising pneumonia; EGPA: eosinophilic granulomatosis with polyangiitis; NSG: necrotising sarcoid granulomatosis; GPA: granulomatosis with polyangiitis; GLILD: granulomatous–lymphocytic interstitial lung disease; HP: hypersensitivity pneumonitis; PLCH: pulmonary Langerhans cell histiocytosis.
Tables
- TABLE 1
Differential diagnosis of granulomatous lung diseases
Infectious lung diseases Mycobacteria Tuberculosis and nontuberculous mycobacteriosis Fungal infection Cryptococcus, Coccidioides, Histoplasma, Blastomyces and Aspergillus Aspiration pneumonia Others Syphilis, Hansen's disease (leprosy), tularaemia, cat scratch disease, parasitic infections and Whipple's disease Noninfectious lung diseases Inflammatory Sarcoidosis Necrotising sarcoid granulomatosis Bronchocentric granulomatosis Inflammatory bowel disease Exposure/toxins Hypersensitivity pneumonitis Drugs (methotrexate, interferon, Bacillus Calmette-Guérin, infliximab, etanercept, leflunomide, mesalamine and sirolimus) Hot tub lung Berylliosis Talc Metals (aluminium and zirconium) Foreign body reaction Vasculitis Granulomatosis with polyangiitis Eosinophilic granulomatosis with polyangiitis Autoimmune diseases Rheumatoid nodule Malignancy Sarcoid-like lesions Lymphomatoid granulomatosis Others Pulmonary Langerhans cell histiocytosis Granulomatous–lymphocytic interstitial lung disease - TABLE 2
Predictors of hypersensitivity pneumonitis
Variable OR (95% CI) Exposure to a known offending antigen 38.8 (11.6–129.6) Positive precipitating antibodies 5.3 (2.7–10.4) Recurrent episodes of symptoms 3.3 (1.5–7.5) Inspiratory crackles 4.5 (1.8–11.7) Symptoms 4–8 h after exposure 7.2 (1.8–28.6) Weight loss 2.0 (1.8–28.6) Reproduced and modified from [89] with permission from the publisher.
Supplementary Material
F. Bonella ERR-0012-2017_Bonella
