Hypersensitivity pneumonitis – experiences in treatment so far and opening up new possibilities

Abstract

Introduction/Objective Hypersensitivity pneumonitis is a diagnostic and therapeutic challenge. It occurs due to an excessive immune response to inhaling an antigen (bacteria, fungi, or protozoa) to which the patient was previously sensitized. This study analyzes the clinical characteristics of patients during a 10-year period (2014–2023) treated at the Institute for Pulmonary Diseases of Vojvodina.

Methods A retrospective study was conducted including 74 patients. The first phase included data collection, the second phase included statistical data processing, and the third included the description of the obtained statistical parameters and discussion.

Results The average age was 57.61 ± 12.6 years; 52.7% were men, and 56.8% were non-smokers. Most patients had one or more comorbidities (70.3%). There were only 27 (36.5%) patients hospitalized more than three times. Progression and regression occurred in 14 (28%) patients each, while cessation occurred in 22 (44%). Fatal outcomes occurred in 7 (9.5%). It was determined that in patients with three or more comorbidities, ≥ 3 hospitalizations (9; 34.6%) occurred more often than < 3 hospitalizations (2; 4.2%) (Fisher’s exact test = 14.46; p = 0.04). By comparing the prognosis of the disease with the number of hospitalizations, we found a statistically significant association (Fisher’s exact test = 13.95; p = 0.001). The progression of the disease in patients with ≥ 3 hospitalizations (10; 62.5%) occurred more often than in patients with < 3 hospitalizations (4; 11.8%).

Conclusion To obtain adequate data on the success of therapy and its impact on slowing down the disease, further monitoring of patients who are on antifibrotic therapy is necessary.

Keywords: antifibrotic therapy; extrinsic allergic alveolitis; progressive pulmonary fibrosis