Fibrotic hypersensitivity pneumonitis (fHP) is a chronic, often progressive fibrosing form of hypersensitivity pneumonitis and is also often categorized as a form of interstitial lung disease. Manifestations previously categorized as chronic hypersensitivity pneumonitis now fall under this category. As with other forms of hypersensitivity pneumonitis it is caused by inhaled antigenic exposures.
Radiographic features
CT
The associated lung fibrosis can frequently demonstrate bronchocentricity 5
The collaborative American Thoracic Society (ATS), Japanese Respiratory Society (JRS), and Latin American Thoracic Association (ALAT) guidelines suggest using the three descriptors "typical", "compatible with", or "indeterminatefor" fibrotic hypersensitivity pneumonitis 3:
typical hypersensitivity pneumonitis
coarse reticulation and minimal honeycombing in a random axial distribution with no zonal predominance
1. Varone F, Iovene B, Sgalla G et al. Fibrotic Hypersensitivity Pneumonitis: Diagnosis and Management. Lung. 2020;198(3):429-40. doi:10.1007/s00408-020-00360-3 - Pubmed
2. Barnes H & Johannson K. Management of Fibrotic Hypersensitivity Pneumonitis. Clin Chest Med. 2021;42(2):311-9. doi:10.1016/j.ccm.2021.03.007 - Pubmed
3. Raghu G, Remy-Jardin M, Ryerson C et al. Diagnosis of Hypersensitivity Pneumonitis in Adults. An Official ATS/JRS/ALAT Clinical Practice Guideline. Am J Respir Crit Care Med. 2020;202(3):e36-69. doi:10.1164/rccm.202005-2032ST - Pubmed
4. Guler S, Wohlfarth E, Berezowska S, Geiser T, Ebner L, Funke-Chambour M. Performance of a Diagnostic Algorithm for Fibrotic Hypersensitivity Pneumonitis. A Case-Control Study. Respir Res. 2021;22(1):120. doi:10.1186/s12931-021-01727-7 - Pubmed
5. Kouranos V, Jacob J, Nicholson A, Renzoni E. Fibrotic Hypersensitivity Pneumonitis: Key Issues in Diagnosis and Management. J Clin Med. 2017;6(6):62. doi:10.3390/jcm6060062 - Pubmed
6. Salisbury M, Myers J, Belloli E, Kazerooni E, Martinez F, Flaherty K. Diagnosis and Treatment of Fibrotic Hypersensitivity Pneumonia. Where We Stand and Where We Need to Go. Am J Respir Crit Care Med. 2017;196(6):690-9. doi:10.1164/rccm.201608-1675PP - Pubmed
7. Simon L.F. Walsh & Luca Richeldi. Demystifying Fibrotic Hypersensitivity Pneumonitis Diagnosis: It's All About Shades of Grey. Eur Respir J. 2019;54(1):1900906. doi:10.1183/13993003.00906-2019 - Pubmed
Unable to process the form. Check for errors and try again.