Hypersensitivity pneumonitis history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
According to duration of illness, the clinical presentation of Hypersentivity Pneumonitis is categorized as Acute, Subacute, or Chronic.
History and Symptoms
Patients with HP present with positive history based on the acute, subacute, or chronic status:
- Acute HP
- Flulike syndrome
- Fever, malaise, chills, dyspnea , headache , chest tightness, and cough.
- Significantly exposure leads to development of HP within hours.
- Symptoms gradually resolve after removal of exposure.
- Re-exposure leads to recurrence of symptoms.
- Flulike syndrome
- Subacute hypersensitivity pneumonitis
- Insidious in onset.
- Symptoms present over weeks to months.
- Symptoms include dyspnea, cough, and fatigue.
- Patients may present with anorexia and weight loss.
Subacute (intermittent) hypersensitivity pneumonitis clinical presentation is as follows:
- Insidious onset of productive cough, dyspnea, fatigue over weeks to months
- Progression to persistent cough and dyspnea
- May occur in individuals with frequent acute reactions
- May note anorexia and/or weight loss
Chronic hypersensitivity pneumonitis clinical presentation is as follows:
- May have unrecognized or untreated acute/subacute disease
- Often presents with no obvious acute episodes, presents as insidious disease
- Progressive dyspnea, cough, fatigue, malaise, and/or weight loss
Acute HP
- Symptoms develop 4-6 hours following exposure to the inciting agent and then generally resolve spontaneously within 12 hours to several days upon removal of the inciting agent.
- Symptoms include the abrupt development of
- fever
- chills
- malaise
- cough
- chest tightness
- dyspnea
- headache
- malaise.
Subacute or Intermittent HP
- Symptoms include the gradual development of
- productive cough
- dyspnea
- fatigue
- anorexia
- weight loss
- The same symptoms may be present in patients who experience acute attacks on multiple occasions.
Patients with subacute HP present similarly to patients with acute disease, but symptoms are less severe and last longer.
Chronic HP
Patients often lack a history of acute episodes.
They have an insidious onset of cough, progressive dyspnea, fatigue, and weight loss.
Removing exposure results in only partial improvement.