Abstract
Purpose of review: Hypersensitivity pneumonitis (HP) remains a challenging diagnosis, and a cause is not established in up to 50% of cases. This paper aims to update clinicians on traditional and novel occupational causes of HP, and clinical tools for identifying of causative exposures and antigens. Recent findings: Metalworking fluid has become the most frequently cited occupational cause of HP, though geographical variations in exposures exist. Occupational HP is usually associated with work-related symptoms. Systematically derived questionnaires and compendia for HP have been developed for use in cryptogenic disease, though have previously lacked validation; these may help identify inciting antigens or relevant occupational exposures. Summary: Clinicians should enquire about job roles and work-relatedness of symptoms when considering a diagnosis of HP. Outbreaks of metalworking fluid associated HP from around the world are well described, so clinicians should remain vigilant. The usual classification for causative antigen includes animal and plant proteins, fungi, bacteria, low-molecular weight chemicals and metals; however novel occupational exposures and work processes are frequently reported.Citation
Walters GI, Huntley CC. Novel occupational causes of hypersensitivity pneumonitis. Curr Opin Allergy Clin Immunol. 2023 Apr 1;23(2):85-91. doi: 10.1097/ACI.0000000000000894. Epub 2023 Jan 20Type
ArticlePMID
36752361Publisher
Lippincott, Williams & Wilkinsae974a485f413a2113503eed53cd6c53
10.1097/ACI.0000000000000894