RT Journal Article
SR Electronic
T1 Environmental exposures in 513 patients of hypersensitivity pneumonitis: Prospective ILD India registry
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA3882
DO 10.1183/13993003.congress-2016.PA3882
VO 48
IS suppl 60
A1 Sheetu Singh
A1 Bridget Collins
A1 Bharat Bhushen Sharma
A1 Jyotsana M. Joshi
A1 Deepak Talwar
A1 Sandeep Katiyar
A1 Nishtha Singh
A1 Lawrence Ho
A1 Jai Kumar Samaria
A1 Parthasarthi Bhattacharya
A1 Rakesh Gupta
A1 Sudhir Chaudhari
A1 Tejraj Singh
A1 Vijay Moond
A1 Sudhakar Pipavath
A1 Jitesh Ahuja
A1 Ravindran Chetambath
A1 Aloke G. Ghoshal
A1 Nirmal Kumar Jain
A1 H.J. Gayathri Joshy
A1 Surya Kant
A1 Parvaiz Koul
A1 Raja Dhar
A1 Rajesh Swarnkar
A1 Surendra K. Sharma
A1 Dhrubajyoti Roy
A1 Kripesh R. Sarmah
A1 Bhavin Jankharia
A1 Rodney A. Schmidt
A1 Virendra Singh
A1 Ganesh Raghu
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA3882.abstract
AB Background: Prospective data about environmental exposures resulting in Hypersensitivity pneumonitis(HP)is limited.Aim: Purpose of the study was to identify environmental factors associated with HP in India.Methods: Consecutive adult patients diagnosed with interstitial lung disease(ILD)were enrolled prospectively in ILD-India registry from 27 centers across India(March2012-June2015)by site principal investigators(SPI)with help of detailed case report forms(CRFs).Inclusion criterion were high resolution computed tomography(HRCT)chest images per protocol for all patients. Diagnosis was made by ILD experts through multidisciplinary discussions(MDD)at the national coordinating center(NCC),Jaipur,India and finalized by ILD experts at center for ILD (CILD),University of Washington,Seattle,USA.Results: Among 1084 ILD patients, 513 patients were diagnosed with HP based on MDD without lung biopsy in 495(18 out of 24 biopsies had histology consistent with HP). The interobserverkappa score was 0.580(NCC/CILD), 0.492(SPI/NCC) and 0.271(SPI/CILD). 67.1%, 13.1%, 14.8% patients resided in urban, sub-urban and rural areas respectively. Common domestic environmental exposure were to aircoolers(48.1%),airconditioners(26.3%), birds(21.4%), molds(20.7%); occupational(5.1%) and unknown antigens(24.7%).(Pending results of fungal cultures from some aircoolers will be presented)Conclusion: 47.3% patients enrolled in ILD India registry had HP; most were exposed to aircoolers. Low interobserver agreement between SPIs and MDD at CILD emphasizes the need for MDD for precise diagnosis. CRFs designed to gather exposure history may surface otherwise occult factors and lead to better understanding and management of HP.