Hypersensitivity pneumonitis medical therapy: Difference between revisions
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{{Hypersensitivity pneumonitis}} | {{Hypersensitivity pneumonitis}} | ||
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== Overview == | == Overview == | ||
The best treatment is to avoid the provoking allergen, as chronic exposure can cause permanent damage. [[Corticosteroids]] such as [[Prednisolone]] may help to control [[Hypersensitivity pneumonitis history and symptoms|symptoms]] but may produce side-effects. | The best treatment is to avoid the provoking allergen, as chronic exposure can cause permanent damage. [[Corticosteroids]] such as [[Prednisolone]] may help to control [[Hypersensitivity pneumonitis history and symptoms|symptoms]] but may produce side-effects. | ||
=== Antigen avoidance === | |||
If the responsible inhaled antigen can be identified, the most effective therapy is complete avoidance. Acute disease remits without specific therapy. This may prove difficult or impractical when a new home or new job would be required. When complete elimination or avoidance of the allergen exposure is not possible, exposure minimization with protective equipment or environmental treatment is a potential alternative. Respirators may provide satisfactory personal air purification for workplace environments. Alternatively, use of fungicides, dehumidification, mold removal or other remediation services may also sufficiently reduce ambient antigen burden. Patients with disease progression in the setting of ongoing exposure should still be strongly counseled on antigen avoidance even if drastic measures such as relocation to a new job or home are required. | |||
=== Corticosteroid therapy === | |||
Corticosteroid therapy may be indicated for acute symptomatic relief and may accelerate the initial recovery in persons with severe disease.<sup> [[null 59]] </sup>In long-term prospective follow-up studies, however, prognosis was not affected. | |||
Treatment regimens for hypersensitivity pneumonitis vary according to the prescriber. A conceivable initial empiric treatment dose is prednisone 0.5-1 mg/kg/day for 1-2 weeks in acute hypersensitivity pneumonitis or 4-8 weeks for subacute/chronic hypersensitivity pneumonitis followed by a gradual taper to off or maintenance dose of approximately 10 mg/day. Continued therapy should be guided by clinical response, pulmonary function, and radiographic improvement. Maintenance doses are not always required, particularly if the patient is removed from exposure. | |||
==Medical Therapy== | ==Medical Therapy== | ||
* The mainstay of treatment for HP is: | |||
** Environmental control | |||
** Antigen exposure control | |||
* If the condition of the patient does not improve then medical therapy in the form of corticosteroid is used. | |||
'''Antigen Control''' | |||
* Mainstay in treatment is complete control of exposure to antigen. | |||
==References== | ==References== | ||
Revision as of 19:25, 27 February 2018
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Hypersensitivity pneumonitis Microchapters |
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Differentiating Hypersensitivity pneumonitis from other Diseases |
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Diagnosis |
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Treatment |
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Hypersensitivity pneumonitis medical therapy On the Web |
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American Roentgen Ray Society Images of Hypersensitivity pneumonitis medical therapy |
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Directions to Hospitals Treating Hypersensitivity pneumonitis |
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Risk calculators and risk factors for Hypersensitivity pneumonitis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
The best treatment is to avoid the provoking allergen, as chronic exposure can cause permanent damage. Corticosteroids such as Prednisolone may help to control symptoms but may produce side-effects.
Antigen avoidance
If the responsible inhaled antigen can be identified, the most effective therapy is complete avoidance. Acute disease remits without specific therapy. This may prove difficult or impractical when a new home or new job would be required. When complete elimination or avoidance of the allergen exposure is not possible, exposure minimization with protective equipment or environmental treatment is a potential alternative. Respirators may provide satisfactory personal air purification for workplace environments. Alternatively, use of fungicides, dehumidification, mold removal or other remediation services may also sufficiently reduce ambient antigen burden. Patients with disease progression in the setting of ongoing exposure should still be strongly counseled on antigen avoidance even if drastic measures such as relocation to a new job or home are required.
Corticosteroid therapy
Corticosteroid therapy may be indicated for acute symptomatic relief and may accelerate the initial recovery in persons with severe disease. null 59 In long-term prospective follow-up studies, however, prognosis was not affected.
Treatment regimens for hypersensitivity pneumonitis vary according to the prescriber. A conceivable initial empiric treatment dose is prednisone 0.5-1 mg/kg/day for 1-2 weeks in acute hypersensitivity pneumonitis or 4-8 weeks for subacute/chronic hypersensitivity pneumonitis followed by a gradual taper to off or maintenance dose of approximately 10 mg/day. Continued therapy should be guided by clinical response, pulmonary function, and radiographic improvement. Maintenance doses are not always required, particularly if the patient is removed from exposure.
Medical Therapy
- The mainstay of treatment for HP is:
- Environmental control
- Antigen exposure control
- If the condition of the patient does not improve then medical therapy in the form of corticosteroid is used.
Antigen Control
- Mainstay in treatment is complete control of exposure to antigen.