title: Hypersensitivity pneumonitis: clinical perspectives.
abstract: BACKGROUND
  The clinical course of hypersensitivity pneumonitis (HSP) is highly variable and its diagnosis clinically challenging.
  
  
  OBJECTIVE
  To provide a concise review of major clinical, radiographic, and laboratory findings that permits diagnosis of HSP from the standpoint of a clinician/pulmonologist.
  
  
  METHODS
  Review of major contemporary and historical literature in combination with the author's experience and viewpoints.
  
  
  CONCLUSIONS
  The approach to the diagnosis of HSP is multidisciplinary. For patients being evaluated for unexplained dyspnea and cough and an unknown interstitial disease process, the initial evaluation should include detailed environmental and occupational histories with ancillary testing such as serology, chest imaging, inhalation challenges, and bronchoalveolar lavage, as indicated. In uncertain cases, lung biopsy is recommended.
authors.affiliation: University of Massachusetts Medical School, Department of Medicine, 55 Lake Ave N, Worcester, MA 01655, USA. mark.madison@umassmed.edu
authors.forename: J Mark
authors.initials: JM
authors.lastname: Madison
mesh_terms: D000542:Alveolitis, Extrinsic Allergic / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology / Q000276:immunology; D003371:Cough / Q000175:diagnosis; D003952:Diagnostic Imaging; D004391:Dust; D004417:Dyspnea / Q000175:diagnosis; D006801:Humans; D016273:Occupational Exposure
chemical_list: D004391:Dust