Diagnostik und Therapie der exogen-allergischen Alveolitis

Zusammenfassung

Die exogen-allergische Alveolitis (EAA) ist eine immunvermittelte interstitielle Lungenerkrankungen (ILD) bei zuvor sensibilisierten Personen, bedingt durch die Inhalation einer Vielzahl von möglichen Antigenen. Die Verlaufsform der akuten EAA wird häufig fehldiagnostiziert, die chronische, insbesondere chronisch-fibrotische Form ist differenzialdiagnostisch oft schwierig von anderen fibrotischen ILDs zu unterscheiden. Die vorliegende Leitlinie zur Diagnostik und Therapie ersetzt die deutschen Empfehlungen zur Diagnostik der EAA von 2007 und ergänzt diese explizit um den Aspekt der chronischen, insbesondere chronisch-fibrotischen Form der EAA sowie erstmals auch um Therapieempfehlungen. Auf Grundlage der aktuellen wissenschaftlichen Evidenz wurden durch eine multidisziplinäre Expertengruppe zu 12 Fragen konsentierte Empfehlungen erstellt, die wichtige zusammenfassende Aussagen zur Diagnosefindung und zu therapeutischen Strategien bei Patienten mit einer EAA enthalten. Andere aktuelle nationale und internationale Leitlinien zur EAA und ILDs wurden berücksichtigt. Ausführliche Hintergrundtexte mit allgemeinen Informationen zur EAA dienen dem vertieften Verständnis und dem Umgang mit den Empfehlungen.

Abstract

Hypersensitivity pneumonitis (HP) is an immune-mediated interstitial lung disease (ILD) in sensitized individuals caused by a large variety of inhaled antigens. The clinical form of acute HP is often misdiagnosed, while the chronic form, especially the chronic fibrotic HP, is difficult to differentiate from other fibrotic ILDs. The present guideline for the diagnosis and treatment of HP replaces the former German recommendations for the diagnosis of HP from 2007 and is amended explicitly by the issue of the chronic fibrotic form, as well as by treatment recommendations for the first time. The evidence was discussed by a multidisciplinary committee of experts. Then, recommendations were formulated for twelve questions on important issues of diagnosis and treatment strategies. Recently published national and international guidelines for ILDs and HP were considered. Detailed background information on HP is useful for a deeper insight into HP and the handling of the guideline.

Publikationsverlauf

Artikel online veröffentlicht:
03. September 2024

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