Hypersensitivity pneumonitis medical therapy

The best treatment is to avoid the provoking allergen, as chronic exposure can cause permanent damage. Corticosteroids such as Prednisolone may help to control symptoms but may produce side-effects.

• The mainstay of treatment for HP is:
  • Environmental control/ Antigen exposure control
  • Corticosteroid therapy

Antigen Control

• Mainstay in treatment is complete control of exposure to antigen.
• If complete avoidance of antigen exposure cannot be done then the following can be done:
  • Protective equipment can be used to minimize exposure.
  • Personal air purification can be achieved with the use of respirators.
  • Ambient antigen burden can be reduced using dehumidification, mold removal and fungicides.

Corticosteroid therapy

• Corticosteroid therapy can be used to treat acute symptoms.
• In severe disease, corticosteroid use can accelerate the initial recovery.
• Preferred regimen in acute HP: prednisone 0.5-1 mg/kg/day for 7-14 days.
• Preferred regimen in subacute HP: prednisone 0.5-1 mg/kg/day for 4-8 weeks.
• Preferred regimen for maintenance : prednisone 10 mg/day.
  • Maintenance dose is only required if the patient cannot be removed from antigen exposure.

Continued therapy should be guided by clinical response, pulmonary function, and radiographic improvement. Maintenance doses are not always required, particularly if the patient is removed from exposure.

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