TY - JOUR
T1 - Hypersensitivity pneumonitis
T2 - Clinical manifestations-Prospective data from the interstitial lung disease-India registry
AU - Singh, Sheetu
AU - Collins, Bridget
AU - Sharma, Bharat
AU - Joshi, Jyotsana
AU - Talwar, Deepak
AU - Katiyar, Sandeep
AU - Singh, Nishtha
AU - Ho, Lawrence
AU - Samaria, Jai
AU - Bhattacharya, Parthasarthi
AU - Chaudhari, Sudhir
AU - Singh, Tejraj
AU - Pilania, Khushboo
AU - Pipavath, Sudhakar
AU - Ahuja, Jitesh
AU - Chetambath, Ravindran
AU - Ghoshal, Aloke
AU - Jain, Nirmal
AU - Gayathri Devi, H.
AU - Kant, Surya
AU - Koul, Parvaiz
AU - Dhar, Raja
AU - Swarnakar, Rajesh
AU - Katiyar, Subodh
AU - Jindal, Arpita
AU - Mangal, Daya
AU - Singh, Virendra
AU - Raghu, Ganesh
N1 - Funding Information:
The Registry was funded by the Indian Chest Society.
Publisher Copyright:
© 2019 Indian Chest Society.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Context: Multiple environmental factors are associated with development of hypersensitivity pneumonitis (HP), and diagnostic algorithms for the diagnosis of HP have been proposed in recent perspectives. Aims: We analyzed the data of patients with HP from interstitial lung disease (ILD)-India registry. The analysis was performed to (1) find the prevalence of HP, (2) reclassify HP as per a recently proposed classification criterion to assess the level of diagnostic certainty, and (3) identify the causative agents for HP. Setting and Designs: This was a prospective multicenter study of consecutive, consenting adult patients with new-onset ILD from 27 centers across India (March 2012-April 2015). Materials and Methods: The diagnoses were based on prespecified working clinical criteria and multidisciplinary discussions. To assess strength of diagnosis based on available clinical information, patients with HP were subclassified into definite HP, HP with high level of confidence, and HP with low level of confidence using a recent classification scheme. Results: Five hundred and thirteen of 1084 patients with new-onset ILD were clinically diagnosed with HP and subclassified as HP with high level of confidence (380, 74.1%), HP with low level of confidence (106, 20.7%), and definite HP (27, 5.3%). Exposures among patients with HP were birds (odds ratios [OR]: 3.52, P < 0.001), air-conditioners (OR: 2.23, P < 0.001), molds (OR: 1.79, P < 0.001), rural residence (OR: 1.64, P < 0.05), and air-coolers (OR: 1.45, P < 0.05). Conclusions: About 47.3% of patients with new-onset ILD in India were diagnosed with HP, the majority of whom were diagnosed as HP with a high level of confidence. The most common exposures were birds, cooling devices, and visible molds.
AB - Context: Multiple environmental factors are associated with development of hypersensitivity pneumonitis (HP), and diagnostic algorithms for the diagnosis of HP have been proposed in recent perspectives. Aims: We analyzed the data of patients with HP from interstitial lung disease (ILD)-India registry. The analysis was performed to (1) find the prevalence of HP, (2) reclassify HP as per a recently proposed classification criterion to assess the level of diagnostic certainty, and (3) identify the causative agents for HP. Setting and Designs: This was a prospective multicenter study of consecutive, consenting adult patients with new-onset ILD from 27 centers across India (March 2012-April 2015). Materials and Methods: The diagnoses were based on prespecified working clinical criteria and multidisciplinary discussions. To assess strength of diagnosis based on available clinical information, patients with HP were subclassified into definite HP, HP with high level of confidence, and HP with low level of confidence using a recent classification scheme. Results: Five hundred and thirteen of 1084 patients with new-onset ILD were clinically diagnosed with HP and subclassified as HP with high level of confidence (380, 74.1%), HP with low level of confidence (106, 20.7%), and definite HP (27, 5.3%). Exposures among patients with HP were birds (odds ratios [OR]: 3.52, P < 0.001), air-conditioners (OR: 2.23, P < 0.001), molds (OR: 1.79, P < 0.001), rural residence (OR: 1.64, P < 0.05), and air-coolers (OR: 1.45, P < 0.05). Conclusions: About 47.3% of patients with new-onset ILD in India were diagnosed with HP, the majority of whom were diagnosed as HP with a high level of confidence. The most common exposures were birds, cooling devices, and visible molds.
KW - Environmental exposures
KW - extrinsic allergic alveolitis
KW - hypersensitivity pneumonitis
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U2 - 10.4103/lungindia.lungindia_263_19
DO - 10.4103/lungindia.lungindia_263_19
M3 - Article
C2 - 31670294
AN - SCOPUS:85074731097
SN - 0970-2113
VL - 36
SP - 476
EP - 482
JO - Lung India
JF - Lung India
IS - 6
ER -