Methods
hypersensitivity pneumonitis, desaturation, honeycombing [Pulmonary hypertension, hypoxia, fibrosis, volume loss, Nodular opacities, ground-glass, pulmonary hypertension
HYPERSENSITIVITY PNEUMONITIS, HYPOXIA, CYSTIC CHANGES, FIBROSIS, PULMONARY HYPERTENSION, TRACTION BRONCHIECTASIS
A cross sectional study that was held in a tertiary referral center “Kasr Alainy hospital, Department of pulmonary medicine, ILD unit, approved from research ethical committee, Cairo University (MS-131-2019). It included 60 patients with established diagnosis of hypersensitivity pneumonitis coming for follow up in ILD unit during the period from August 2019 to October 2020.Diagnosis of HP is based on An official ATS/JRS/ALAT clinical practice guideline, 2020 [Assessment of oxygenation status by arterial blood gases sampling, hypoxia was considered when POSix minutes walk test (6MWT) was performed according to ATS 2002 guidelines for all patients as a marker of exercise tolerance with assessment of desaturation difference between the baseline SPOPulmonary function test in the form of spirometry by Master Screen PFT 2012, CareFusion 234 GmbH, Germany (V-781267-057 version 03.00), Restriction was classified as mild, moderate and severe (FVC% predicted 80–60%, 40–60% and < 40% respectively) according to ATS guidelines 1994 [HRCT chest was done using (Siemens 16-channel). HRCT chest findings which are suggestive of HP include; ground-glass. Nodular opacities, air-trapping in the mid to upper portion of the lung lobes, head-cheese sign (combination of GGO and mosaic parenchyma),Peribronchial consolidations, fibrosis, Cystic changes, fibrotic HP includes the following patterns: reticulation, traction bronchiectasis, volume loss, with or without evidence of honeycombing [Pulmonary hypertension was diagnosed by echocardiography based on evaluation of the echocardiographic probability of pulmonary hypertension, according to ESC/ERS guidelines, 2015 [Right heart catheterization was performed for 4 cases with high probability of pulmonary hypertension using multi-lumen swan ganz catheter. PH is defined as an increase in mean pulmonary arterial pressure (mPAP) ≥ 25 mmHg at rest as assessed by right heart catheterization (RHC). Pre-capillary PH, defined by a pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg and a PVR. 3 Wood units (WU) [Patients were classified into two groups based on echocardiography; HP without PH (low probability for PH) included 43 patients and HP with PH including 17 patients (intermediate probability = 13 patients) and (high probability = 4 patients).