title: Chronic hypersensitivity pneumonitis.
abstract: Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies. Treatment options are limited, but lung transplantation results in greater survival in comparison to idiopathic pulmonary fibrosis. Randomized trials with new antifibrotic agents are necessary.
authors.affiliation: Interstitial Lung Diseases Program.
authors.forename: Carlos Ac
authors.initials: CA
authors.lastname: Pereira
authors.affiliation: Pulmonology Postgraduate, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Andréa
authors.initials: A
authors.lastname: Gimenez
authors.affiliation: Pulmonology Postgraduate, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Lilian
authors.initials: L
authors.lastname: Kuranishi
authors.affiliation: Pulmonology Postgraduate, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Karin
authors.initials: K
authors.lastname: Storrer
keywords: HRCT; diffuse lung disease; extrinsic allergic alveolitis; farmers lung; interstitial lung diseases; lung immune response