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Evaluation of the determining mechanisms of effort limitation and exercise capacity in patients with hypersensitivity pneumonitis


Hypersensitivity pneumonitis (HP) is a typically immune-mediated disease that manifests as interstitial lung disease (ILD) in susceptible individuals after exposure to an identified or unidentified agent. The prevalence of HP varies according to regional, climatic, occupational and environmental characteristics. Available studies estimate an incidence between 0.3 and 0.9 per 100,000 individuals, although this number may be even higher. The disease can be divided into fibrotic and non-fibrotic HP depending on tomographic or histopathological findings. The predominant symptoms are cough and dyspnea, in addition to lung rales on auscultation and possibly an association with systemic conditions such as weight loss and malaise. Treatment is mainly based on withdrawal from exposure. The use of steroids and immunosuppressants is based on retrospective studies and seems to have little benefit in the course of the disease. Few studies have evaluated the performance of patients with PH on exertion. It is believed that ventilatory and circulatory mechanisms are responsible for the limitation presented by patients. This work aims to clarify this gap by evaluating a large population with HP. All patients with HP at the HCFMUSP interstitial diseases' outpatient clinic will be evaluated with field tests, pulmonary function tests, ergospirometry, transthoracic echocardiography and right cardiac catheterization in order to clarify the doubts that still persist about the pathophysiological aspects of exercise limitation in these patients. (AU)

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