Occupational Asthma Reference
Bellanger A, Reboux G, Rouzet A, Barrera C, Rocchi S, Scherer E, Millon L,
Hypersensitivity pneumonitis: A new strategy for serodiagnosis and environmental surveys,
Respir Med,
2019;150:101-106,doi.org/10.1016/j.rmed.2019.02.019
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Keywords: HP, EAA, review, IgG, precipitins,
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Abstract
We propose a strategy for serodiagnosis of hypersensitivity pneumonitis (HP): 1) question patients about their private or occupational activity, or visit him on site; 2) select panels of six somatic specific antigens appropriate for each type of exposure; 3) and use ELISA to test concomitantly two recombinant antigens highly specific to Farmer's lung, Metalworking-fluid HP, and for Bird fancier's lung. The serodiagnosis provides an immunological argument that may complete radiological, functional lung exploration and clinical features; 4) If the serodiagnosis is negative but the suspicion of HP is strong, a microbial analysis of the patient's specific exposure is conducted; 5) “A la carte” antigens are produced from the microorganisms isolated in the patient's environment sample and tested; 6) Finally, the patient may be asked to undergo a specific inhalation challenge with the offending antigens in a safety cabin, or to avoid his usual environment for a few days.
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