Lacasse et al developed a score for predicting hypersensitivity pneumonitis based on clinical and laboratory findings. This can help make the diagnosis without the need for bronchoscopy or lung biopsy. The authors are from multiple medical institutions from around the world (Canada, Japan, Mexico, USA, France, Germany, Spain, and Finland).
Parameters:
(1) history of exposure to a known offending antigen
(2) serum precipitating antibodies to the antigen
(3) recurrent episodes of symptoms
(4) inspiratory crackles
(5) symptoms 4-8 hours after exposure
(6) weight
|
Parameter |
Finding |
Points |
|
history of exposure to a known offending antigen |
negative |
0 |
|
|
positive |
1 |
|
precipitating antibodies to the antigen |
negative |
0 |
|
|
positive |
1 |
|
recurrent episodes |
negative |
0 |
|
|
present |
1 |
|
inspiratory crackles |
absent |
0 |
|
|
present |
1 |
|
symptoms 4-8 hours after exposure |
absent |
0 |
|
|
present |
1 |
|
weight |
gain or stable |
0 |
|
|
loss |
1 |
X =
= (3.66 * (points for known exposure)) + (1.68 * (points for serum antibodies)) + (1.20 * (points for recurrent episodes)) + (1.51 * (points for inspiratory crackles)) + (1.97 * (points for symptoms 4-8 hours)) + (0.70 * (points for weight loss)) - 6.57
probability of hypersensitivity pneumonitis =
= 1 / (1 + EXP((-1) * X))
Purpose: To evaluate a person for hypersensitivity pneumonitis using the clinical score of Lacasse et al.
Specialty: Pulmonology, Immunology/Rheumatology
Objective: clinical diagnosis, including family history for genetics, other testing
ICD-10: J67,
