PT  - JOURNAL ARTICLE
AU  - Tananchai Petnak
AU  - Teng Moua
TI  - Exposure assessment in hypersensitivity pneumonitis: a comprehensive review and proposed screening questionnaire
AID  - 10.1183/23120541.00230-2020
DP  - 2020 Jul 01
TA  - ERJ Open Research
PG  - 00230-2020
VI  - 6
IP  - 3
4099  - http://openres.ersjournals.com/content/6/3/00230-2020.short
4100  - http://openres.ersjournals.com/content/6/3/00230-2020.full
SO  - erjor2020 Jul 01; 6
AB  - Hypersensitivity pneumonitis is an immune-mediated inflammatory lung disease characterised by the inhalation of environmental antigens leading to acute and chronic lung injury. Along with suggestive clinical and radiological findings, history and timing of suspected antigen exposure are important elements for diagnostic confidence. Unfortunately, many diagnoses remain tentative and based on vague and imprecise environmental or material exposure histories. To date, there has not been a comprehensive report highlighting the frequency and type of environmental exposure that might lead to or support a more systematic approach to antigen identification. We performed a comprehensive literature review to identify and classify causative antigens and their associated environmental contexts or source materials, with emphasis on the extent of the supportive literature for each exposure type. Eligible publications were those that reported unique inciting antigens and their respective environments or contexts. A clinical questionnaire was then proposed based on this review to better support diagnosis of hypersensitivity pneumonitis when antigen testing or other clinical and radiological variables are inconclusive or incomplete.Exposure history in hypersensitivity pneumonitis may be thought of in terms of an inciting antigen or its exposure setting or source. An approach reflecting a comprehensive assessment of the published literature may improve diagnosis and management. https://bit.ly/2AJp5vr