Resumen
Definición
Anamnesis y examen
Principales factores de diagnóstico
- exposição a antígeno de proteína aviária, especialmente excrementos
- bolor no ambiente de trabalho
- exposição ocupacional a substâncias químicas
- dispneia
- tosse
Otros factores de diagnóstico
- febre/calafrios
- mal-estar
- perda de peso/anorexia
- estertores bibasilares
- estertores difusos
- baqueteamento digital
Factores de riesgo
- tabagismo
- infecção viral
- exposição a antígeno proteico aviário
- exposição a antígeno de bolor
- exposição a antígeno bacteriano
- exposição a di-isocianato (por exemplo, resina epóxi)
- exposição a antígeno ácido de anidrido (por exemplo, recuperadores de pintura)
- Exposição a fluidos de usinagem com metais
- nitrofurantoína, metotrexato, roxitromicina e rituximabe
- cigarros eletrônicos
- sertralina
- medicina ayurvédica
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- radiografia torácica
- tomografia computadorizada (TC) do tórax
- IgG ou IgA específica para antígeno sérico
- testes de função pulmonar
- capacidade de difusão do monóxido de carbono
Pruebas diagnósticas que deben considerarse
- lavagem broncoalveolar
- biópsia pulmonar
Algoritmo de tratamiento
todos os pacientes
Colaboradores
Autores
Leslie Grammer, MD
Professor
Northwestern University Feinberg School of Medicine
Director
Ernest S. Bazley Asthma and Allergy Center
Clinic Practice Director
Allergy-Immunology
Northwestern Medical Faculty Foundation
Chicago
IL
Divulgaciones
LG declares that she has no competing interests.
Revisores por pares
Jordan Fink, MD
Professor of Pediatrics
Allergy-Immunology Division
Medical College of Wisconsin
Milwaukee
WI
Divulgaciones
JF is an author of a number of references cited in this topic.
Alec Chessman, MD
Professor of Family Medicine
Medical University of South Carolina
Charleston
SC
Divulgaciones
AC declares that he has no competing interests.
Toby M. Maher, MB, MSc, PhD, MRCP
Consultant Respiratory Physician
Interstitial Lung Disease Unit
Royal Brompton Hospital
London
UK
Divulgaciones
TMM has received consultancy fees from GSK, Actelion, and Philips Respironics. He has received lecture fees from Astra Zeneca and holds an unrestricted industry-academic grant from GSK.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referencias
Artículos principales
Raghu G, Remy-Jardin M, Ryerson CJ, et al. Diagnosis of hypersensitivity pneumonitis in adults. An Official ATS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2020 Aug 1;202(3):e36-69.Texto completo Resumen
Quirce S, Vandenplas O, Campo P, et al. Occupational hypersensitivity pneumonitis: an EAACI position paper. Allergy. 2016 Jun;71(6):765-79.Texto completo Resumen
Fernández Pérez ER, Travis WD, Lynch DA, et al. Diagnosis and evaluation of hypersensitivity pneumonitis: CHEST guideline and expert panel report. Chest. 2021 Aug;160(2):e97-156.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
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