Pediatric hypersensitivity pneumonitis: literature update and proposal of a diagnostic algorithm.
Children
Cough
Dyspnea
Extrinsic allergic alveolitis
Hypersensitivity pneumonitis
Interstitial pneumonia
Pediatric
Journal
Italian journal of pediatrics
ISSN: 1824-7288
Titre abrégé: Ital J Pediatr
Pays: England
ID NLM: 101510759
Informations de publication
Date de publication:
28 Mar 2022
28 Mar 2022
Historique:
received:
22
10
2021
accepted:
09
03
2022
entrez:
29
3
2022
pubmed:
30
3
2022
medline:
31
3
2022
Statut:
epublish
Résumé
Hypersensitivity pneumonitis (HP) is a rare disease in childhood with the prevalence of 4 cases per 1 million children and an incidence of 2 cases per year. The average age of diagnosis at pediatric age is approximately 10 years. The pathogenesis of HP is characterized by an immunological reaction caused by recurrent exposure to triggering environmental agents (mostly bird antigens in children). The clinical picture of HP is complex and variable in children, often presenting in subacute forms with cough and exertion dyspnea. A diagnosis of HP should be considered in patients with an identified exposure to a triggering antigen, respiratory symptoms, and radiologic signs of interstitial lung disease. Blood tests and pulmonary function tests (PFT) support the diagnosis. Bronchoscopy (with bronchoalveolar lavage and tissue biopsy) may be needed in unclear cases. Antigen provocation test is rarely required. Of note, the persistence of symptoms despite various treatment regimens may support HP diagnosis. The avoidance of single/multiple triggers is crucial for effective treatment. No evidence- based guidelines for treatment are available; in particular, the role of systemic glucocorticoids in children is unclear. With adequate antigen avoidance, the prognosis in children with HP is generally favorable.
Identifiants
pubmed: 35346317
doi: 10.1186/s13052-022-01239-0
pii: 10.1186/s13052-022-01239-0
pmc: PMC8962565
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
51Investigateurs
Carla Mastrorilli
(C)
Luca Pecoraro
(L)
Stefania Arasi
(S)
Simona Barni
(S)
Lucia Caminiti
(L)
Riccardo Castagnoli
(R)
Mattia Giovannini
(M)
Lucia Liotti
(L)
Francesca Mori
(F)
Francesca Saretta
(F)
Gian Luigi Marseglia
(GL)
Elio Novembre
(E)
Informations de copyright
© 2022. The Author(s).
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