Roy Artal (Pulmonologist and Critical Care Physician) gives expert video advice on: What are the common symptoms of hypersensitivity pneumonitis?; How is hypersensitivity pneumonitis treated? and more...
What is 'hypersensitivity pneumonitis'?
Hypersensitivity pneumonitis is an inflammatory or immune condition that develops within the lungs as a result of inhaling airborne particles. These particles can be anything from organic material, such as mold or feathers or bird droppings, things of that nature, to inorganic compounds such as certain types of chemicals that can trigger this type of reaction in the lungs.
What does pneumonitis mean?
Pneumonitis is a general medical term that means inflammation in the lung. Many different types of conditions can cause a pneumonitis. There can be an inflammatory pneumonitis, a chemical pneumonitis, an infectious pneumonitis and so forth.
What are the common causes of hypersensitivity pneumonitis?
The common causes of hypersensitivity pneumonitis can include inhaled proteins such as molds or funguses in the home. There's certainly been a lot of discussion in the press recently about the implications of mold growing in one's home and what the health implications are for that. Other conditions in which one might work with a variety of proteins or substances can include veterinarians who work with various animal furs and various animal droppings. There's something called pigeon breeder's lung where people develop hypersensitivity pneumonitis related to the proteins from the pigeon. Other workers such as farmers might develop hypersensitivity pneumonitis related to mold that could be found in haystacks and so forth.
What are the common symptoms of hypersensitivity pneumonitis?
The common systems of hypersensitivity pneumonitis are really quite legion because the disease itself can present in very different ways. It can present from anything such as a minimal cough that might be chronic over months and even years sometimes, to low grade fevers, to acute shortness of breath, to coughing up phlegm, to chest pain. It is really dependent on the type of the exposure, the degree of the exposure and over how long it has been taking place.
How is hypersensitivity pneumonitis diagnosed?
Hypersensitivity pneumonitis is diagnosed most importantly on the basis of a history that is compatible with this type of phenomenon, and that's why it is so important that when you see these patients you really have to take a very detailed history not just of the work environment but of the home environment. Do they have pets at home? Do they engage in certain hobbies? Woodworkers, for example, can develop hypersensitivity pneumonitis and there are certain types of woods where the protein or the sawdust that is created from these woods are very well known to be associated with the development of this type of pneumonitis. Taking a very detailed work history, home history, hobby history, finding out what materials are in the home, asking about things such as mold in the home, inquiring about the possibility of water damage in the home, taking a pet history and so forth are all critical in coming up with a diagnosis of hypersensitivity pneumonitis.
How is hypersensitivity pneumonitis treated?
Hypersensitivity pneumonitis is treated first and foremost by taking the affected individual out of the offending environment. That is absolutely the most critical part of the treatment of hypersensitivity pneumonitis, to prevent additional antigenic exposure. Antigen is basically a medical term that means the product that you are responding to or the protein or item in the air that you are responding to. Get the person who is suffering from this condition away from that product or away from that agent. And then in terms of additional treatments, they can include such things as steroids, sometimes other immune-suppressive medications, but obviously those decisions are going to be made in conjunction with the treating pulmonologist.
Is hypersensitivity pneumonitis curable?
Hypersensitivity pneumonitis is curable, potentially. It really depends on the stage in which the condition is identified. If it's caught early when it's in the inflammation stage, then it's a reversible condition in which there's no permanent damage done, but if somebody is exposed to these products over the course of months and years, then inflammation can actually lead to scarring and the development of fibrosis. A scar is unfortunately not reversible.