背景:ATS/JRS/ALAT过敏性肺炎诊断指南(GL为HP)于2020年发布。加湿器肺和夏季型HP是HP的形式,但目前尚不清楚是否可以使用GLforHP进行诊断。这项研究检查了加湿器肺和夏季型HP可以诊断为HP的GL的信心水平。
方法:数据来自23例加湿器肺患者和20例夏季型HP患者(平均年龄,67.3和57.4年,分别)在2012年10月至2022年1月之间诊断,进行回顾性审查。我们评估了高分辨率计算机断层扫描(HRCT)模式,支气管肺泡灌洗液(BALF)的发现,暴露,和组织病理学发现,以确定可以使用HP的GL进行HP诊断的信心水平。
结果:HRCT模式在5例(22%)中被分类为典型HP,在18例(78%)湿化器肺患者中与HP兼容,在17例(85%)中被认为是典型HP,在3例(15%)夏季型患者中与HP兼容。HP诊断的置信水平为2(8.7%),14名中等(60.9%),7例(30.4%)湿化器肺患者低。它在12(60%)中确定,高3(15%),5例(25%)夏季型HP患者中度。
结论:在许多患者中,HP的GL在诊断湿化器肺方面具有中等至低的置信度。然而,对夏季型HP患者有明确的至高的信心.
BACKGROUND: The ATS/JRS/ALAT
Guidelines for the Diagnosis of Hypersensitivity Pneumonitis (GL for HP) were published in 2020. Humidifier lung and summer-type HP are forms of HP, but it is unclear whether they can be diagnosed using GL for HP. This study examined the level of confidence where humidifier lung and summer-type HP can be diagnosed with GL for HP.
METHODS: Data from 23 patients with humidifier lung and 20 patients with summer-type HP (mean age, 67.3 and 57.4 years, respectively) diagnosed between October 2012 and January 2022 were retrospectively reviewed. We evaluated high resolution computed tomography (HRCT) patterns, bronchoalveolar lavage fluid (BALF) findings, exposures, and histopathological findings to determine the level of confidence where a diagnosis of HP could be made using the GL for HP.
RESULTS: HRCT pattern was classified as typical HP in 5 (22%) and compatible with HP in 18 (78%) patients with humidifier lung and considered as typical HP in 17 (85%) and compatible with HP in 3 (15%) patients with summer-type. The confidence level for diagnosis of HP was definite in 2 (8.7%), moderate in 14 (60.9%), and low in 7 (30.4%) patients with humidifier lung. It was definite in 12 (60%), high in 3 (15%), and moderate in 5 (25%) patients with summer-type HP.
CONCLUSIONS: GL for HP showed utility in diagnosing humidifier lung in many patients with a moderate to low confidence. However, there was a definite to high confidence for patients with summer-type HP.