Long‐term outcomes in chronic hypersensitivity pneumonitis. Issue 5 (13th January 2019)

• Record Type: Journal Article
• Authors: Ojanguren, Iñigo; Morell, Ferran; Ramón, María‐Antonia; Villar, Ana; Romero, Christian; Cruz, María Jesús; Muñoz, Xavier
• Is Part Of: Allergy. Volume 74:Issue 5(2019)
• Page Start: 944
• Page End: 952
• Publication Date: 2019-01-13
• Subjects: follow‐up -- hypersensitivity pneumonitis -- lung fibrosis -- lymphocytes -- transfer factor of the lung for carbon monoxide; Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.13692
• Languages: English
• ISSNs: 0105-4538

Abstract

Abstract: Introduction: The objective of this study was to analyze mortality, possible predictors of long‐term survival, and health‐related quality of life of a large chronic hypersensitivity pneumonitis (CHP) patient sample. Methods: Longitudinal study in patients diagnosed with CHP during 2004‐2013, followed for at least 1 year. Patients remaining alive and consenting to participate had a follow‐up visit during 2015, including a complete pulmonary function study and the EuroQol‐5D and Beck Depression and Anxiety Inventories. Results: Out of the 160 patients finally included, 87 remained alive. Seventy‐three had died or underwent lung transplantation at the time of the study with a median survival of 7.0 (4.4‐14.5) years. A Cox proportional risk model showed that factors associated with lower survival were as follows: increased age, a low percentage of lymphocytes in bronchoalveolar lavage (BAL), a decreased transfer factor of thelung forcarbonmonoxide (DLCO), presence of honeycomb in the high‐resolution chest scan (HRCT), and the usual interstitial pneumonia (UIP) histologic pattern. At follow‐up, all patients presented an EuroQol‐5D score <0.8 and 21(50%) and 9(28.6%) subjects presented a probable anxiety and depressive syndrome, respectively. Conclusion: CHP is a severe disease with a bad mid‐term prognosis. Lymphocyte values in BAL and DLCO values at baseline, presence of honeycomb in HRCT, and UIP histologic pattern were found to be predictors of survival. Early accurate diagnosis of the disease is fundamental for prompt initiation of antigen avoidance. Abstract : Chronic hypersensitivity pneumonitis is a severe disease with a bad mid‐term prognosis. Lymphocyte values in BAL and DLCO values at baseline, presence of honeycomb in HRCT, and UIP histologic pattern were found to be predictors of survival. At follow‐up, all patients presented an EuroQol‐5D score < 0.8 and a probable anxiety and depressive syndrome.