icon fsr

文献詳細

雑誌文献

medicina61巻1号

2024年01月発行

文献概要

特集 その知見は臨床を変える?—エキスパートが解説! 内科における最新論文 呼吸器

過敏性肺炎に関する最新のトピックス

著者: 飯島裕基1

所属機関: 1東京医科歯科大学呼吸器内科

ページ範囲:P.30 - P.36

文献購入ページに移動
Point
◎予後の観点から,病型分類が急性・慢性から線維性・非線維性へ変更された.
◎抗原曝露歴,気管支肺胞洗浄液(BALF)所見,画像所見,病理所見などから総合的に診断する.
◎抗原回避が最重要だが,改善しない症例に対してはステロイドや抗線維化薬が用いられる.

参考文献

1)Costabel U, et al:Hypersensitivity pneumonitis. Nat Rev Dis Primers 6:65, 2020 PMID 32764620
2)Raghu G, et al:Diagnosis of hypersensitivity pneumonitis in adults. An Official ATS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 202:e36-e69, 2020 PMID 32706311
3)日本呼吸器学会過敏性肺炎診療指針2022作成委員会(編):過敏性肺炎診療指針2022,日本呼吸器学会,2022
4)Ando M, et al:Japanese summer-type hypersensitivity pneumonitis. Geographic distribution, home environment, and clinical characteristics of 621 cases. Am Rev Respir Dis 144:765-769, 1991 PMID 1928946
5)Okamoto T, et al:Nationwide epidemiological survey of chronic hypersensitivity pneumonitis in Japan. Respir Investig 51:191-199, 2013 PMID 23978646
6)Ohnishi H, et al:Seasonal variation of serum KL-6 concentrations is greater in patients with hypersensitivity pneumonitis. BMC Pulm Med 14:129, 2014 PMID 25098177
7)Okamoto T, et al:Seasonal variation of serum KL-6 and SP-D levels in bird-related hypersensitivity pneumonitis. Sarcoidosis Vasc Diffuse Lung Dis 31: 364-367, 2015 PMID 2591150
8)Ryerson CJ, et al:A standardized diagnostic ontology for fibrotic interstitial lung disease. An international working group perspective. Am J Respir Crit Care Med 196:1249-1254, 2017 PMID 28414524
9)Fernández Pérez ER, et al:Diagnosis and evaluation of hypersensitivity pneumonitis;CHEST guideline and expert panel report. Chest 160:e97-e156, 2021 PMID 33861992
10)Vasakova M, et al:Hypersensitivity pneumonitis;Perspectives in diagnosis and management. Am J Respir Crit Care Med 196:680-689, 2017 PMID 28598197
11)Tsutsui T, et al:Antigen avoidance tests for diagnosis of chronic hypersensitivity pneumonitis. Respir Investig 53:217-224, 2015 PMID 26344611
12)Barnett J, et al:Variable utility of mosaic attenuation to distinguish fibrotic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis. Eur Respir J 54:1900531, 2019 PMID 31164428
13)Takemura T, et al:Pathological differentiation of chronic hypersensitivity pneumonitis from idiopathic pulmonary fibrosis/usual interstitial pneumonia. Histopathology 61:1026-1035, 2012 PMID 22882269
14)Fernández Pérez ER, et al:Identifying an inciting antigen is associated with improved survival in patients with chronic hypersensitivity pneumonitis. Chest 144:1644-1651, 2013 PMID 23828161
15)Petnak T, et al:Antigen identification and avoidance on outcomes in fibrotic hypersensitivity pneumonitis. Eur Respir J 60:2101336, 2022 PMID 35236720
16)Wells AU, et al:Nintedanib in patients with progressive fibrosing interstitial lung diseases—subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial;A randomised, double-blind, placebo-controlled, parallel-group trial. The Lancet Respiratory Medicine 8:453-460, 2020 PMID 32145830

掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1189

印刷版ISSN:0025-7699

雑誌購入ページに移動
icon up
あなたは医療従事者ですか?