Table 3

Statements not reaching consensus agreement for the assessment of HP diagnosis and/or cause in patients with unexplained ILD (n=54)

Statements% agree
In day-to-day practice, the following tests are useful in helping to differentiate HP from other forms of ILD:

  • Lymphocyte proliferation tests.

  • Home or workplace visit.

  • Specific inhalation challenge (hospital based).

19
48
35
In patients where HP is the first choice clinical and radiological diagnosis, a BAL differential cell count:

  • Is not required if there is a clear history of exposure.

  • Is not required if there is a clear history of exposure and an elevated level of specific IgG to a known cause.

59
61
HP is commonly attributed to ‘an idiopathic disease’.54
Normal levels of specific IgG to avian proteins effectively exclude bird or feather down/duvet exposures as the cause of HP in exposed individuals.15
BAL lymphocytosis may persist following cessation of exposure and is not a reliable method of identifying ongoing exposure.43

  • BAL, bronchoalveolar lavage; HP, hypersensitivity pneumonitis; ILD, interstitial lung disease.