Serum Specific Antibodies Do Not Seem to Have an Additional Role in the Diagnosis of Hypersensitivity Pneumonitis
Contenuto principale dell'articolo
Keywords
Abstract
Background: We aimed to investigate the contribution of serum IgG testing to the history of exposure in the diagnosis of fibrotic hypersensitivity pneumonitis. Methods: A single-center, retrospective, cross-sectional study including 63 patients pathologically diagnosed with fibrotic hypersensitivity pneumonitis in line with the guidelines of the American Thoracic Society. Descriptive statistics were presented and Kappa statistic was performed to evaluate the compatibility between panel and the history of exposure. Results: The median age was 63 (22-81) years and 34 (54%) were male. Forty-six patients (73%) had a positive history of exposure. Thirty-nine patients (61.9%) had a positive HP/Avian panel. The most common exposure agent was mold (34.9%), followed by parakeet (31.7%). The antibody detected the most was penicillium chrysogenum lgG (36.5%), followed by aspergillus fumigatus (31.8%). There was no compatibility between HP/Avian panel and history of exposure (kappa coefficient= 0.18, p= 0.14). When the exposure was only assessed based on the history, 4 (6.35%) patients were diagnosed as fibrotic hypersensitivity pneumonitis with low confidence, 6 (9.52%) with moderate confidence, 11 (17.46%) with high confidence and 42 (66.67%) with definite confidence; whereas 4 (6.35%) patients were diagnosed as fibrotic hypersensitivity pneumonitis with low confidence, 6 (9.52%) with moderate confidence, 9 (14.29%) patients with high confidence and 44 (69.84%) patients with definite confidence if exposure was evaluated with history and/or panel. Conclusions: Serum specific precipitating antibody panel does not seem to provide additional value to the history of exposure in the diagnosis of fibrotic hypersensitivity pneumonitis.
Riferimenti bibliografici
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14. Salisbury ML, Gross BH, Chughtai A, et al. Development and validation of a radiological diagnosis model for hypersensitivity pneumonitis. Eur Respir J. 2018;52(2):1800443. Published 2018 Aug 16. Doi: 10.1183/13993003.00443-2018
15. Morell F, Villar A, Montero MÁ, et al. Chronic hypersensitivity pneumonitis in patients diagnosed with idiopathic pulmonary fibrosis: a prospective case-cohort study. Lancet Respir Med. 2013;1(9):685-694. Doi: 10.1016/S2213-2600(13)70191-7
16. Fenoglio CM, Reboux G, Sudre B, et al. Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis. Eur Respir J. 2007;29(4):706-712. Doi: 10.1183/09031936.00001006
17. Jenkins AR, Chua A, Chami H, et al. Questionnaires or Serum Immunoglobulin G Testing in the Diagnosis of Hypersensitivity Pneumonitis among Patients with Interstitial Lung Disease. Ann Am Thorac Soc. 2021;18(1):130-147. Doi: 10.1513/AnnalsATS.202005-419OC
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19. Vasakova M, Morell F, Walsh S, Leslie K, Raghu G. Hypersensitivity Pneumonitis: Perspectives in Diagnosis and Management. Am J Respir Crit Care Med. 2017;196(6):680-689. Doi: 10.1164/rccm.201611-2201PP
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21. Meyer KC, Raghu G, Baughman RP, et al. An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med. 2012;185(9):1004-1014. Doi: 10.1164/rccm.201202-0320ST
22. Ussavarungsi K, Kern RM, Roden AC, Ryu JH, Edell ES. Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease: Retrospective Analysis of 74 Cases. Chest. 2017;151(2):400-408. Doi: 10.1016/j.chest.2016.09.002
23. Giacomi F, Andreano A, Faverio P, et al. Utility of precipitating antibody testing in the diagnostic evaluation of chronic hypersensitivity pneumonia. Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(2):149-155. Doi: 10.36141/svdld.v34i2.5467
24. Nogueira R, Melo N, Novais E Bastos H, et al. Hypersensitivity pneumonitis: Antigen diversity and disease implications. Pulmonology. 2019;25(2):97-108. Doi: 10.1016/j.pulmoe.2018.07.003
25. Fernández Pérez ER, Travis WD, Lynch DA, et al. Diagnosis and Evaluation of Hypersensitivity Pneumonitis: CHEST Guideline and Expert Panel Report. Chest. 2021;160(2):e97-e156. Doi: 10.1016/j.chest.2021.03.066
26. Morell F, Villar A, Ojanguren I, Muñoz X, Cruz MJ. Hypersensitivity Pneumonitis: Challenges in Diagnosis and Management, Avoiding Surgical Lung Biopsy. Semin Respir Crit Care Med. 2016;37(3):395-405. Doi: 10.1055/s-0036-1580692
27. Morisset J, Johannson KA, Jones KD, et al. Identification of Diagnostic Criteria for Chronic Hypersensitivity Pneumonitis: An International Modified Delphi Survey. Am J Respir Crit Care Med. 2018;197(8):1036-1044. Doi: 10.1164/rccm.201710-1986OC
28. Jędrych ME, Szturmowicz M, Bestry I, Kuś J. Alergiczne zapalenie pęcherzyków płucnych – kryteria rozpoznania, leczenie, rokowanie i zapobieganie [Hypersensitivity pneumonitis: Diagnostic criteria, treatment, prognosis and prevention]. Med Pr. 2016;67(4):517-527. Doi: 10.13075/mp.5893.00406
29. Szturmowicz M, Garczewska B, Jędrych ME, et al. The value of serum precipitins against specific antigens in patients diagnosed with hypersensitivity pneumonitis - retrospective study. Cent Eur J Immunol. 2019;44(4):390-394. Doi: 10.5114/ceji.2019.92791
30. Millon L, Rognon B, Valot B, et al. Common peptide epitopes induce cross-reactivity in hypersensitivity pneumonitis serodiagnosis. J Allergy Clin Immunol. 2016;138(6):1738-1741.e6. Doi: 10.1016/j.jaci.2016.06.037
31. Rognon B, Barrera C, Monod M, et al. Identification of Antigenic Proteins from Lichtheimia corymbifera for Farmer's Lung Disease Diagnosis. PLoS One. 2016;11(8):e0160888. Published 2016 Aug 4. Doi: 10.1371/journal.pone.0160888
32. Barrera C, Millon L, Rognon B, et al. Immunoreactive proteins of Saccharopolyspora rectivirgula for farmer's lung serodiagnosis. Proteomics Clin Appl. 2014;8(11-12):971-981. Doi: 10.1002/prca.201400024
33. De Sadeleer LJ, Hermans F, De Dycker E, et al. Effects of Corticosteroid Treatment and Antigen Avoidance in a Large Hypersensitivity Pneumonitis Cohort: A Single-Centre Cohort Study. J Clin Med. 2018;8(1):14. Published 2018 Dec 21. Doi: 10.3390/jcm8010014
34. Ojanguren I, Morell F, Ramón MA, et al. Long-term outcomes in chronic hypersensitivity pneumonitis. Allergy. 2019;74(5):944-952. Doi: 10.1111/all.13692
35. Wang LJ, Cai HR, Xiao YL, Wang Y, Cao MS. Clinical characteristics and outcomes of hypersensitivity pneumonitis: a population-based study in China [published correction appears in Chin Med J (Engl). 2021 Jan 11;134(3):378]. Chin Med J (Engl). 2019;132(11):1283-1292. Doi: 10.1097/CM9.0000000000000256
36. Salisbury ML, Myers JL, Belloli EA, Kazerooni EA, Martinez FJ, Flaherty KR. 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):690-699. Doi: 10.1164/rccm.201608-1675PP
37. Yang SR, Beasley MB, Churg A, et al. Diagnosis of Hypersensitivity Pneumonitis: Review and Summary of American College of Chest Physicians Statement. Am J Surg Pathol. 2022;46(4):e71-e93. Doi: 10.1097/PAS.0000000000001827
38. Lee CT, Adegunsoye A, Chung JH, et al. Characteristics and Prevalence of Domestic and Occupational Inhala-tional Exposures Across Interstitial Lung Diseases. Chest. 2021;160(1):209-218. Doi: 10.1016/j.chest.2021.02.026
2. Basis of Disease. Kumar V, Abbas AK, Fausto N, Aster JC, eds. Robbins and Cotran Pathologic. 8th ed. Philadelp-hia, Pa: Saunders; 2010.
3. Adkinson NF. Hypersensitivity Pneumonitis. Middleton's Allergy: Principles and Practice. 8th Ed. Saunders; 2013.
4. Hanak V, Golbin JM, Hartman TE, Ryu JH. High-resolution CT findings of parenchymal fibrosis correlate with prognosis in hypersensitivity pneumonitis. Chest. 2008;134(1):133-138. Doi: 10.1378/chest.07-3005
5. Fernández Pérez ER, Swigris JJ, Forssén AV, et al. Identifying an inciting antigen is associated with improved survival in patients with chronic hypersensitivity pneumonitis. Chest. 2013;144(5):1644-1651. Doi: 10.1378/chest.12-2685
6. Mooney JJ, Elicker BM, Urbania TH, et al. Radiographic fibrosis score predicts survival in hypersensitivity pneumonitis. Chest. 2013;144(2):586-592. Doi: 10.1378/chest.12-2623
7. Johannson KA, Elicker BM, Vittinghoff E, et al. A diagnostic model for chronic hypersensitivity pneumonitis. Thorax. 2016;71(10):951-954. doi:10.1136/thoraxjnl-2016-208286
8. Fernández Pérez ER, Kong AM, Raimundo K, Koelsch TL, Kulkarni R, Cole AL. Epidemiology of Hypersensitivity Pneumonitis among an Insured Population in the United States: A Claims-based Cohort Analysis. Ann Am Thorac Soc. 2018;15(4):460-469. Doi: 10.1513/AnnalsATS.201704-288OC
9. Bando M, Ohno S, Hosono T, et al. Risk of Acute Exacerbation After Video-assisted Thoracoscopic Lung Biopsy for Interstitial Lung Disease. J Bronchology Interv Pulmonol. 2009;16(4):229-235. Doi: 10.1097/LBR.0b013e3181b767cc
10. Troy LK, Grainge C, Corte TJ, et al. Diagnostic accuracy of transbronchial lung cryobiopsy for interstitial lung disease diagnosis (COLDICE): a prospective, comparative study. Lancet Respir Med. 2020;8(2):171-181. Doi: 10.1016/S2213-2600(19)30342-X
11. Hanak V, Golbin JM, Ryu JH. Causes and presenting features in 85 consecutive patients with hypersensitivity pneumonitis. Mayo Clin Proc. 2007;82(7):812-816. Doi: 10.4065/82.7.812
12. Raghu G, Remy-Jardin M, Ryerson CJ, et al. Diagnosis of Hypersensitivity Pneumonitis in Adults. An Official ATS/JRS/ALAT Clinical Practice Guideline [published correction appears in Am J Respir Crit Care Med. 2021 Jan 1;203(1):150-151] [published correction appears in Am J Respir Crit Care Med. 2022 Aug 15;206(4):518]. Am J Respir Crit Care Med. 2020;202(3):e36-e69. Doi: 10.1164/rccm.202005-2032ST
13. Vasakova M, Morell F, Walsh S, Leslie K, Raghu G. Hypersensitivity Pneumonitis: Perspectives in Diagnosis and Management. Am J Respir Crit Care Med. 2017;196(6):680-689. Doi: 10.1164/rccm.201611-2201PP
14. Salisbury ML, Gross BH, Chughtai A, et al. Development and validation of a radiological diagnosis model for hypersensitivity pneumonitis. Eur Respir J. 2018;52(2):1800443. Published 2018 Aug 16. Doi: 10.1183/13993003.00443-2018
15. Morell F, Villar A, Montero MÁ, et al. Chronic hypersensitivity pneumonitis in patients diagnosed with idiopathic pulmonary fibrosis: a prospective case-cohort study. Lancet Respir Med. 2013;1(9):685-694. Doi: 10.1016/S2213-2600(13)70191-7
16. Fenoglio CM, Reboux G, Sudre B, et al. Diagnostic value of serum precipitins to mould antigens in active hypersensitivity pneumonitis. Eur Respir J. 2007;29(4):706-712. Doi: 10.1183/09031936.00001006
17. Jenkins AR, Chua A, Chami H, et al. Questionnaires or Serum Immunoglobulin G Testing in the Diagnosis of Hypersensitivity Pneumonitis among Patients with Interstitial Lung Disease. Ann Am Thorac Soc. 2021;18(1):130-147. Doi: 10.1513/AnnalsATS.202005-419OC
18. Marinescu DC, Raghu G, Remy-Jardin M, et al. Integration and Application of Clinical Practice Guidelines for the Diagnosis of Idiopathic Pulmonary Fibrosis and Fibrotic Hypersensitivity Pneumonitis. Chest. 2022;162(3):614-629. Doi: 10.1016/j.chest.2022.06.013
19. Vasakova M, Morell F, Walsh S, Leslie K, Raghu G. Hypersensitivity Pneumonitis: Perspectives in Diagnosis and Management. Am J Respir Crit Care Med. 2017;196(6):680-689. Doi: 10.1164/rccm.201611-2201PP
20. Hypersensitivity Pneumonitis FEIA Panel II, Mayo Clinic Laboratories; Hypersensitivity Pneumonitis Panel, Test Code: Y165, Viracor Eurofins.
21. Meyer KC, Raghu G, Baughman RP, et al. An official American Thoracic Society clinical practice guideline: the clinical utility of bronchoalveolar lavage cellular analysis in interstitial lung disease. Am J Respir Crit Care Med. 2012;185(9):1004-1014. Doi: 10.1164/rccm.201202-0320ST
22. Ussavarungsi K, Kern RM, Roden AC, Ryu JH, Edell ES. Transbronchial Cryobiopsy in Diffuse Parenchymal Lung Disease: Retrospective Analysis of 74 Cases. Chest. 2017;151(2):400-408. Doi: 10.1016/j.chest.2016.09.002
23. Giacomi F, Andreano A, Faverio P, et al. Utility of precipitating antibody testing in the diagnostic evaluation of chronic hypersensitivity pneumonia. Sarcoidosis Vasc Diffuse Lung Dis. 2017;34(2):149-155. Doi: 10.36141/svdld.v34i2.5467
24. Nogueira R, Melo N, Novais E Bastos H, et al. Hypersensitivity pneumonitis: Antigen diversity and disease implications. Pulmonology. 2019;25(2):97-108. Doi: 10.1016/j.pulmoe.2018.07.003
25. Fernández Pérez ER, Travis WD, Lynch DA, et al. Diagnosis and Evaluation of Hypersensitivity Pneumonitis: CHEST Guideline and Expert Panel Report. Chest. 2021;160(2):e97-e156. Doi: 10.1016/j.chest.2021.03.066
26. Morell F, Villar A, Ojanguren I, Muñoz X, Cruz MJ. Hypersensitivity Pneumonitis: Challenges in Diagnosis and Management, Avoiding Surgical Lung Biopsy. Semin Respir Crit Care Med. 2016;37(3):395-405. Doi: 10.1055/s-0036-1580692
27. Morisset J, Johannson KA, Jones KD, et al. Identification of Diagnostic Criteria for Chronic Hypersensitivity Pneumonitis: An International Modified Delphi Survey. Am J Respir Crit Care Med. 2018;197(8):1036-1044. Doi: 10.1164/rccm.201710-1986OC
28. Jędrych ME, Szturmowicz M, Bestry I, Kuś J. Alergiczne zapalenie pęcherzyków płucnych – kryteria rozpoznania, leczenie, rokowanie i zapobieganie [Hypersensitivity pneumonitis: Diagnostic criteria, treatment, prognosis and prevention]. Med Pr. 2016;67(4):517-527. Doi: 10.13075/mp.5893.00406
29. Szturmowicz M, Garczewska B, Jędrych ME, et al. The value of serum precipitins against specific antigens in patients diagnosed with hypersensitivity pneumonitis - retrospective study. Cent Eur J Immunol. 2019;44(4):390-394. Doi: 10.5114/ceji.2019.92791
30. Millon L, Rognon B, Valot B, et al. Common peptide epitopes induce cross-reactivity in hypersensitivity pneumonitis serodiagnosis. J Allergy Clin Immunol. 2016;138(6):1738-1741.e6. Doi: 10.1016/j.jaci.2016.06.037
31. Rognon B, Barrera C, Monod M, et al. Identification of Antigenic Proteins from Lichtheimia corymbifera for Farmer's Lung Disease Diagnosis. PLoS One. 2016;11(8):e0160888. Published 2016 Aug 4. Doi: 10.1371/journal.pone.0160888
32. Barrera C, Millon L, Rognon B, et al. Immunoreactive proteins of Saccharopolyspora rectivirgula for farmer's lung serodiagnosis. Proteomics Clin Appl. 2014;8(11-12):971-981. Doi: 10.1002/prca.201400024
33. De Sadeleer LJ, Hermans F, De Dycker E, et al. Effects of Corticosteroid Treatment and Antigen Avoidance in a Large Hypersensitivity Pneumonitis Cohort: A Single-Centre Cohort Study. J Clin Med. 2018;8(1):14. Published 2018 Dec 21. Doi: 10.3390/jcm8010014
34. Ojanguren I, Morell F, Ramón MA, et al. Long-term outcomes in chronic hypersensitivity pneumonitis. Allergy. 2019;74(5):944-952. Doi: 10.1111/all.13692
35. Wang LJ, Cai HR, Xiao YL, Wang Y, Cao MS. Clinical characteristics and outcomes of hypersensitivity pneumonitis: a population-based study in China [published correction appears in Chin Med J (Engl). 2021 Jan 11;134(3):378]. Chin Med J (Engl). 2019;132(11):1283-1292. Doi: 10.1097/CM9.0000000000000256
36. Salisbury ML, Myers JL, Belloli EA, Kazerooni EA, Martinez FJ, Flaherty KR. 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):690-699. Doi: 10.1164/rccm.201608-1675PP
37. Yang SR, Beasley MB, Churg A, et al. Diagnosis of Hypersensitivity Pneumonitis: Review and Summary of American College of Chest Physicians Statement. Am J Surg Pathol. 2022;46(4):e71-e93. Doi: 10.1097/PAS.0000000000001827
38. Lee CT, Adegunsoye A, Chung JH, et al. Characteristics and Prevalence of Domestic and Occupational Inhala-tional Exposures Across Interstitial Lung Diseases. Chest. 2021;160(1):209-218. Doi: 10.1016/j.chest.2021.02.026
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Oct 24, 2023
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Demirkol B, Satici C, Tanriverdi E, Eren R, Altundas Hatman E, Yardimci HA, et al. Serum Specific Antibodies Do Not Seem to Have an Additional Role in the Diagnosis of Hypersensitivity Pneumonitis. Med Lav [Internet]. 2023 Oct. 24 [cited 2024 Jul. 18];114(5):e2023042. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/14478
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Come citare
1.
Demirkol B, Satici C, Tanriverdi E, Eren R, Altundas Hatman E, Yardimci HA, et al. Serum Specific Antibodies Do Not Seem to Have an Additional Role in the Diagnosis of Hypersensitivity Pneumonitis. Med Lav [Internet]. 2023 Oct. 24 [cited 2024 Jul. 18];114(5):e2023042. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/14478
