RT Journal Article SR Electronic T1 Diagnostic yield of specific inhalation challenge in hypersensitivity pneumonitis JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP 1658 OP 1665 DO 10.1183/09031936.00060714 VO 44 IS 6 A1 Xavier Muñoz A1 Mónica Sánchez-Ortiz A1 Ferran Torres A1 Ana Villar A1 Ferran Morell A1 María-Jesús Cruz YR 2014 UL http://erj.ersjournals.com/content/44/6/1658.abstract AB Reliable methods are needed to diagnose hypersensitivity pneumonitis. The aim of the study was to establish the diagnostic yield of specific inhalation challenge (SIC) in patients with hypersensitivity pneumonitis. All patients with suspected hypersensitivity pneumonitis in whom SIC was performed (n=113) were included. SIC was considered positive when patients showed a decrease of >15% in forced vital capacity (FVC) or >20% in diffusing capacity of the lung for carbon dioxide, or a decrease of 10% to 15% in FVC accompanied by a temperature increase of 0.5°C within 24 h of inhalation of the antigen. SIC was positive to the agents tested in 68 patients: 64 received a diagnosis of hypersensitivity pneumonitis and SIC results were considered false-positive in the remaining four patients. In the SIC-negative group (n=45), 24 patients received a diagnosis of hypersensitivity pneumonitis and SIC results were considered false-negative, and 21 patients were diagnosed with other respiratory diseases. The sensitivity and specificity of the test were 72.7% and 84%, respectively. Having hypersensitivity pneumonitis caused by an antigen other than birds or fungi predicted a false-negative result (p=0.001). In hypersensitivity pneumonitis, positive SIC testing virtually confirms the diagnosis, whereas negative testing does not rule it out, especially when the antigenic sources are not birds or fungi. Specific inhalation challenge can be very useful for establishing the diagnosis of hypersensitivity pneumonitis http://ow.ly/zxszi