Chest
Original ResearchInterstitial Lung DiseaseHigh-Resolution CT Findings of Parenchymal Fibrosis Correlate With Prognosis in Hypersensitivity Pneumonitis*
Section snippets
Patient Population
We conducted a computer-assisted search of the electronic medical records at the Mayo Clinic Rochester, MN, and identified 85 consecutive patients with HP diagnosed during the 6-year period between January 1, 1997, and December 31, 2002. The diagnostic criteria for HP included the following: (1) presence of respiratory symptoms, (2) radiologic evidence of diffuse lung disease, (3) known exposure or a positive serum precipitins to an inciting antigen, and (4) no other identifiable cause for the
Results
The mean (± SD) age in our patient population was 54 ± 14 years and 44 patients were female (64%). In 52 patients (75%), the presumptive antigen was identified by history or serologic testing, and 52 patients (75%) had histopathologic diagnosis of HP. Only one patient was current smoker. Based on the HRCT findings, 26 patients (38%) were classified as fibrotic and 43 patients (63%) were classified as nonfibrotic (Table 1). Patients in the fibrotic group were older, had longer duration of
Discussion
Our study found radiologic evidence of parenchymal fibrosis to be associated with decreased survival in patients with HP. Furthermore, the extent of parenchymal fibrosis, as assessed by semiquantitative visual scoring of CT, correlated with mortality.
HP may lead to progressive clinical deterioration and death in a proportion of patients.5, 10, 11, 12 Mortality in our study was 17%, comparable to reports from other tertiary care referral medical centers.5 The long-term mortality estimates in
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Funding was provided by the Mayo Clinic Foundation.
The authors have no conflicts of interest to disclose.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).