Hypersensitivity Pneumonitis Serology

General

Synonym/Acronym:RationalePatient PreparationNormal FindingsCritical Findings and Potential Interventions

Overview

(Study type: Blood collected in a red-top tube; related body system: Immune and Respiratory systems.)

Hypersensitivity pneumonitis is a respiratory disease caused by the inhalation of organisms from an organic source. Affected and symptomatic individuals demonstrate acute bronchospastic reaction 4 to 6 hr after exposure to the offending antigen. Inhalation of the antigen stimulates the production of immunoglobulin G antibodies. The combination of immune complexing and cell-mediated immunopathogenesis results in a chronic granulomatous pneumonitis of the interstitial space of the lung. Hypersensitivity pneumonitis serology includes detection of antibodies to Aspergillus fumigatus, Saccharopolyspora rectivirgula, Thermoactinomyces vulgaris, Thermoactinomyces sacchari, and Thermoactinomyces candidus. A negative test result does not rule out hypersensitivity pneumonitis as a possible diagnosis, nor does a positive test result confirm the diagnosis. Also, individuals with a positive test result may not exhibit the typical symptoms, and patients with severe symptoms may not have detectable levels of antibody while their disease is inactive. To confirm the diagnosis, it is necessary to obtain a sputum culture and chest x-rays.

Indications

Assist in establishing a diagnosis of hypersensitivity pneumonitis in patients experiencing fever, chills, and dyspnea after repeated exposure to moist organic sources.

Interfering Factors

N/A

Potential Medical Diagnosis: Clinical Significance of Results

Increased in

  • Hypersensitivity pneumonitis

Nursing Implications, Nursing Process, Clinical Judgement

Before the Study: Planning and Implementation


Teaching the Patient What to Expect

  • Discuss how this test can assist in diagnosing pneumonitis.
  • Explain that a blood sample is needed for the test.

After the Study: Implementation & Evaluation Potential Nursing Actions


Treatment Considerations

  • Discuss how to perform deep breathing and pursed-lip breathing to enhance breathing patterns.
  • Advise avoiding the use of tobacco, highly polluted areas, and work environments with hazards such as fumes, dust, and other respiratory pollutants.

Nutritional Considerations

  • Positive test results may be associated with respiratory disease.
  • Malnutrition is commonly seen in patients with severe respiratory disease related to fatigue and lack of appetite.
  • Stress the importance of following the prescribed diet.

Clinical Judgement

  • Consider how to emphasize the efficacy of strict adherence to individualized therapeutic treatment plan to improve respiratory health.

Followup Evaluation and Desired Outcomes

  • Acknowledges contact information provided for the American Lung Association (www.lungusa.org).
  • Agrees to attend smoking cessation programs.
  • Understands the importance of protecting the lungs by avoiding contact with individuals persons who have respiratory infections.

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