GUIDELINES PREDICT DIAGNOSIS OF DIFFICULT-TO-ASSESS HYPERSENSITIVITY PNEUMONITIS
A simple, noninvasive clinical predictive rule has been developed to guide clinical diagnosis for the difficult-to-assess disease called hypersensitivity pneumonitis. Canadian researchers presented data on 400 patients from seven clinical sites in different countries to develop a predictive rule that distinguishes those with the disease. Among the group, there were 116 patients with hypersensitivity pneumonitis (HP) and 284 without the disease. Of the 116 patients with HP, 71 had pigeon breeder's/bird fancier's disease and 25 had farmer's lung. The rule was tested on 261 additional patients to verify its accuracy. HP involves inflammation in the tiny air sacs of the lungs (alveoli) that is caused by an allergic reaction to inhaled organic dusts and occasionally, chemicals. After exposure, the lungs become inflamed and white blood cells accumulate in the walls of the alveoli. If a person has developed hypersensitivity to a specific organic dust, a fever, cough, chill, and shortness of breath typically appear 4 to 8 hours after exposure. The researchers point out that diagnosis of the disease is difficult and often relies on invasive tissue pathology. After identifying appropriate individual components of the history, physical examination, and basic laboratory results, the investigators said that the rule they developed could reduce the number of unnecessary invasive procedures, including surgical biopsy, in patients with typical characteristics of the disease. The study appears in the second issue for October 2003 of the American Thoracic Society's peer-reviewed American Journal of Respiratory and Critical Care Medicine.

MANAGEMENT OF PULMONARY INFECTIONS IN CYSTIC FIBROSIS
Inhaled antibiotics are being used by over 60 percent of U.S. patients with cystic fibrosis (CF) who have tested positive to the most significant pathogen affecting those wi
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Contact: Cathy Carlomagno
ccarlomagno@thoracic.org
212-315-6442
American Thoracic Society
17-Oct-2003

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