Extract
According to a survey study conducted by Wijsenbeek et al. [1], 76% of respiratory physicians believe fibrotic hypersensitivity pneumonitis (fibrotic HP, fHP) should be treated with corticosteroids (CS) as first line treatment. However, data to support such a strategy are limited and confined to acute farmer's lung [2]. Classically, HP patients are classified according to symptom chronicity in acute and chronic HP [3]. Based on new data, however, a stratification according to the (radiological) presence of fibrosis seems more in line with prognosis [4]. In an earlier study, we demonstrated that CS treatment was only beneficial in non-fibrotic HP while CS was not effective in fHP, both in terms of survival, and decline in forced vital capacity (FVC) and diffusing capacity of the lung for carbon monoxide (DLCO) [5]. In the present study, we determined whether the presence of bronchoalveolar lavage lymphocytosis (BAL lymphocytosis, BALL) or honeycombing influences the treatment effect of CS in fHP patients.
Abstract
Low BAL lymphocytosis and presence of honeycombing predict poor outcome and absence of corticosteroid treatment effect in fibrotic hypersensitivity pneumonitis http://bit.ly/2QUl0K6
Acknowledgements
We thank the patients who participated in this study.
Footnotes
Author contributions: Study design: L.J. De Sadeleer and W.A. Wuyts; data retrieval: L.J. De Sadeleer, E. De Dycker and F. Hermans; data analysis: L.J. De Sadeleer; manuscript writing: L.J. De Sadeleer, S.E. Verleden and W.A. Wuyts; reviewing and editing: all authors.
Conflict of interest: L.J. De Sadeleer reports non-financial support for meeting attendance from Roche and Boehringer Ingelheim, outside the submitted work.
Conflict of interest: F. Hermans has nothing to disclose.
Conflict of interest: E. De Dycker has nothing to disclose.
Conflict of interest: J. Yserbyt has nothing to disclose.
Conflict of interest: J.A. Verschakelen has nothing to disclose.
Conflict of interest: E.K. Verbeken has nothing to disclose.
Conflict of interest: G.M. Verleden has nothing to disclose.
Conflict of interest: S.E. Verleden has nothing to disclose.
Conflict of interest: W.A. Wuyts reports grants from Roche and Boehringer Ingelheim, outside the submitted work.
Support statement: Research reported in this publication was supported by the Research Foundation – Flanders and the University Hospitals Leuven (1.8.325.12N). The funding sources were not involved in study design, data collection, data analysis, data interpretation, manuscript writing or the decision to submit the article for publication. Funding information for this article has been deposited with the Crossref Funder Registry.
- Received October 11, 2019.
- Accepted December 26, 2019.
- Copyright ©ERS 2020