Hypersensitivity Pneumonitis (HP)

We can evaluate and help you manage your hypersensitivity pneumonitis, or treat complications caused by lung scarring.
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Hypersensitivity pneumonitis (HP) is a form of lung inflammatory disease that develops after exposure to various triggers, such as mold. 

Hypersensitivity pneumonitis is a potentially progressive lung condition that requires expert care. It is better managed and potentially curable if you catch it early and pinpoint what’s causing it. 

Fortunately, University of Iowa Health Care has pulmonologists and occupational medicine specialists who specialize in treating HP. 

We have the experience it takes to distinguish HP from other lung diseases. We focus on getting to the root of what’s triggering your symptoms. That helps you avoid these triggers—and prevent permanent lung damage. 

What is hypersensitivity pneumonitis?

Hypersensitivity pneumonitis is a unique type of inflammatory lung disease. It is triggered by exposure to one of several substances. These substances may include: 

  • Animal proteins, such as those found in bird droppings or on their feathers 
  • Certain mycobacteria 
  • Certain chemicals 
  • Fungi 
  • Mold 

HP symptoms flare up when you’re exposed to the offending substance. But with HP, continued exposure can eventually cause fibrosis (lung scarring). This type of lung damage is irreversible.

 

There are two types of HP


  • If we catch your HP early, while there is still time for your lungs to heal, you have nonfibrotic HP.  
  • If you’ve already started developing fibrosis, you have fibrotic HP. 

Hypersensitivity pneumonitis symptoms

In its early stages, nonfibrotic HP can cause flu-like symptoms such as: 

  • Chills 
  • Cough 
  • Fever 
  • Shortness of breath 

These symptoms usually develop within a few hours of exposure to the allergen. Then they go away after several hours or days. 

Over time, with repeated exposure—and gradual lung damage—your symptoms get worse. With fibrotic HP, you may have: 

  • A frequent dry, hacking cough 
  • Chronic shortness of breath, especially during activity 
  • Fatigue 
  • Loss of appetite 
  • Unexplained weight loss 

Diagnosing hypersensitivity pneumonitis

To confirm whether you have HP, we’ll perform tests to evaluate your lungs. We’ll also ask detailed questions about your medical history and personal history (such as your occupation, hobbies, and environment). 

We’ll use one or more of these tests to look for signs of HP and lung damage: 

Pulmonary function test: We have you breathe into a device that measures lung function (how well your lungs work). 

Chest imaging: We use imaging procedures to take pictures of your lungs. Radiologists from UI Health Care are skilled at reading these images and determining whether you have HP or something else.  

Bronchoscopy: We guide a catheter (small, flexible tube) through your nose or mouth and into your lungs. This lets us see inside your lungs and, if necessary, perform a biopsy (tissue samples we examine under a microscope).  

Surgical lung biopsy: In some cases, getting tissue samples from your lungs requires surgery. Our experienced thoracic surgeons specialize in this type of surgical biopsy.  

Antibody blood tests: We check your blood for antibodies, or special proteins your body makes in response to common HP allergens. 

The single best way to prevent HP—and its complications—is to stay away from the allergen that’s causing it. 

To narrow down the source of your symptoms, we’ll ask questions about your work and living environments. For example, if you work on a farm, we’ll discuss your exposure to materials (like hay) that can grow mold. If you think the allergen is at home, we’ll ask about your exposure to items like humidifiers and down bedding.  

Once we figure out which allergen is making you sick, we’ll help you take steps to reduce or avoid exposure. 

Hypersensitivity pneumonitis treatment from UI Health Care

If we diagnose your HP early, before it has caused lung damage, we’ll work to heal your lungs. While you recover, you may need treatments to reduce lung inflammation and/or scarring. 

You can take comfort in knowing UI Health Care also offers treatment options for advanced HP. 

Your HP treatment plan 

The treatments you’ll need for HP will depend on several factors. These factors include how long you’ve had your symptoms and whether you’ve already developed permanent scarring in your lungs.  

In addition to limiting or avoiding exposure to the identified allergen, we may recommend the following treatments: 

  • Steroid medicines: Also known as corticosteroids, these medications help reduce lung inflammation. 
  • Immunosuppressants: These medications can help reduce the inflammation in your lungs.. 
  • Anti-fibrotic drugs: These medicines help slow the progression of lung scarring. 
  • Pulmonary rehabilitation: Specially trained therapists teach you exercises to strengthen your lungs and improve your breathing. 
  • Lung transplant: If your lung damage is severe, you may need a lung transplant. One of our transplant surgeons will replace your diseased lung(s) with a healthy donor lung. 

Leading expertise in occupational lung disease

Around half of people who develop HP are exposed in their work environment. If you work in Iowa and develop lung problems on the job, your employer may refer you to the Occupational Medicine Clinic.  

Our occupational medicine team includes pulmonologists who manage lung diseases caused by occupational or environmental exposures. In addition to ordering tests and diagnosing your condition, we can: 

  • Conduct a formal evaluation of your work environment, looking for evidence of allergens that could be causing your symptoms 
  • Recommend personal protective equipment (PPE) that reduces your risk of exposure during work 
  • Prescribe treatments 
  • Refer you to other UI Health Care specialists who can provide any additional tests or treatments you may need

Types of hypersensitivity pneumonitis

Hypersensitivity pneumonitis goes by many other names, which are often based on the occupation or activity that causes it.  

This includes:  

  • Farmer’s lung, caused by an allergy to mold that grows in hay, straw, or grain 
  • Bird fancier’s lung, caused by exposure to proteins in bird droppings or feathers 
  • Hot tub lung, caused by bacteria that can contaminate hot tub water 
  • Humidifier lung, caused by exposure to fungi or bacteria that can accumulate in humidifiers or heating and air conditioning systems 
  • Malt worker’s lung, caused by exposure to fungi that grows in barley 
  • Mushroom worker’s lung, caused by breathing in fungal spores at mushroom farms 
Do you have symptoms of HP?
If you suspect you have hypersensitivity pneumonitis, or you’d like a second opinion about your symptoms, call UI Health Care. We’ll connect you with a pulmonologist who has experience diagnosing and treating HP.
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