%0 Journal Article
%T Hypersensitivity pneumonitis: application of a new diagnostic algorithm to a time series of the disease.
%A Casal A
%A Suárez-Antelo J
%A Riveiro V
%A Ferreiro L
%A Rodríguez-García C
%A de Alegría AM
%A Antúnez JR
%A Tobes ME
%A Otero B
%A Rodríguez-Núñez N
%A Álvarez-Dobaño JM
%A Vargas-Osorio K
%A Gude F
%A Valdés L
%J Expert Rev Respir Med
%V 18
%N 3
%D 2024 Mar-Apr 30
%M 38775489
%F 4.3
%R 10.1080/17476348.2024.2358939
%X UNASSIGNED: The diagnostic criteria for Hypersensitivity pneumonitis (HP) have changed over time. Our aim is to apply a recent diagnostic algorithm to a historical series of patients diagnosed with HP to assess its distribution according to current diagnostic criteria and the diagnostic confidence achieved.
UNASSIGNED: Application to each patient the algorithm criteria. The diagnosis was HP (≥90%), provisional high (70-89%) or low confidence (51-69%) or non-HP (unlikely) (≤50%); or HP, provisional or non-HP, if they had lung biopsy.
UNASSIGNED: 129 patients [mean age 64 ± 12 years; 79 (61.2%) women] were included of which 16 (12.4%) were diagnosed on the basis of high clinical suspicion. After applying the algorithm, 106 patients (82.2%) could be evaluated and 83 (78.3%) had a diagnosis of HP or high confidence. Lung biopsy was able to establish a diagnosis of certainty in another 21 patients and a provisional diagnosis in 9 more [total, 113 (87.6%)]. The 16 patients without strict diagnostic criteria for HP had a low confidence diagnosis. A total of 56 lung biopsies (64.4%) could have been avoided according to the new guidelines.
UNASSIGNED: The application of this algorithm achieves a high diagnostic yield in HP, significantly reducing the number of lung biopsies required.