Factors associated with positive inhalation provocation test results in subjects suspected of having chronic bird-related hypersensitivity pneumonitis

详细信息    查看全文

• 作者：Masahiro Masuo ; M.D. ^{masupulm@tmd.ac.jp} ; Yasunari Miyazaki ; M.D. ; ^{miyazaki.pilm@tmd.ac.jp} ; Kozo Suhara ; M.D. ^{suhara.pulm@tmd.ac.jp} ; Masahiro Ishizuka ; M.D. ^{mishizuka.pulm@tmd.ac.jp} ; Toshihide Fujie ; M.D. ^{tfujie.pulm@tmd.ac.jp} ; Naohiko Inase ; M.D. ^{ninase.pulm@tmd.ac.jp}
• 关键词：BALF ; bronchoalveolar lavage fluid ; BRHP ; bird-related hypersensitivity pneumonitis ; CVD ; collagen-vascular-disease ; HP ; hypersensitivity pneumonitis ; HRCT ; high-resolution computed tomography ; IIP ; idiopathic interstitial pneumonia ; ILD ; interstitial lung disease ; IPF ; idiopathic pulmonary fibrosis ; IPT ; inhalation provocation test ; IPT-PS ; inhalation provocation test prediction score ; LPT ; lymphocyte proliferation test ; OR ; Odds ratio ; PDE ; pigeon dropping extract ; SLB ; surgical lung biopsy ; T
• 刊名：Respiratory Investigation
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：54
• 期：6
• 页码：454-461
• 全文大小：416 K
• 卷排序：54

文摘

Chronic bird-related hypersensitivity pneumonitis (BRHP) is often misdiagnosed as other interstitial lung diseases. While the utility of the inhalation provocation test (IPT) has been reported, the test is not commonly performed. In this study, we aimed to identify significant clinical variables associated with positive inhalation provocation test results in subjects suspected of having chronic BRHP. This would help clinicians decide whether to perform IPT in patients suspected of having chronic BRHP in real-life practice.MethodsWe retrospectively evaluated 107 patients who underwent the IPT for suspected chronic BRHP. We used the IPT as the gold standard diagnostic tool for chronic BRHP.ResultsSpecific antibodies against pigeon dropping extract were documented in 52% of the IPT-positive patients but also in 38% of the IPT-negative patients (p=0.172). By using the logistic regression model, three significant predictors of IPT results were identified as follows: (1) a history of raising birds (odds ratio [OR] 3.112), (2) exposure to birds from the surrounding environment (OR 7.321), (3) white blood cell count (×102/μl; OR 0.959).ConclusionsThis study demonstrates that current or past exposure to avian antigens is a positive predictor of positive IPT results in patients suspected of having chronic BRHP.