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과민성 폐렴의 진단과 치료

Other Titles
 Diagnosis and Treatment of Hypersensitivity Pneumonitis 
Authors
 박무석 
Citation
 JOURNAL OF THE KOREAN MEDICAL ASSOCIATION , Vol.52(1) : 49-58, 2009 
Journal Title
 JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 
ISSN
 1975-8456 
Issue Date
2009
Keywords
Hypersensitivity pneumonitis ; Extrinsic allergic alveolitis ; Interstitial lung disease ; Diagnosis ; Treatment
Abstract
Hypersensitivity pneumonitis (HP), also known as extrinsic allergic alveolitis, is an immunologically mediated granulomatous, inflammatory disease of the lungs caused by repeated inhalation of various antigens. HP may occur in acute, subacute, or chronic forms. Chronic HP may be progressive, irreversible, and evolve to fibrotic interstitial lung disease. The diagnosis of HP can be made from a combination of clinical, laboratory, radiologic, and pathologic findings. A careful environmental and occupational history and establishment of exposure to a known inciting antigen are key factors in making the diagnosis of HP. Serum precipitating antibodies, bronchoalveolar lavage, and lung biopsy may be helpful in making the diagnosis. The pathology of HP is characterized by interstitial lymphocytic infiltration, poorlyformed noncaseating granulomas, cellular bronchiolitis, and fibrosis. In the pathogenesis of HP, recent studies showed that both type III and type IV hypersensitivity reactions are involved and are mediated by immune complexes and Th1 T cells, respectively. IFN-γ is essential for the development of HP, and IL-10 appears to modulate the severity of the disease. TNF-αand TGF- βhave been implicated in development of the pulmonary fibrosis that is seen in chronic HP. Avoidance of organic antigen exposure is the most important factor for the management of HP. There is often an apparent beneficial response to corticosteroids in the cases of severe acute and subacute HP, and for chronic HP that is severe or progressive
Files in This Item:
T200901184.pdf Download
DOI
10.5124/jkma.2009.52.1.49
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Moo Suk(박무석) ORCID logo https://orcid.org/0000-0003-0820-7615
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/103813
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