Fibrotic hypersensitivity pneumonitis: case report and proposal of sources of exposure in our environment

Authors

  • Domingo Pérez Bejarano Ministerio de Salud Pública y Bienestar Social, Hospital General de Luque, Servicio de Medicina Interna- Neumología. Luque, Paraguay https://orcid.org/0000-0002-9842-4789

DOI:

https://doi.org/10.53732/rccsalud/2023.e5204

Keywords:

pneumonia, interstitial lung diseases, extrinsic allergic alveolitis

Abstract

An excessive immune response to inhaled antigens in some susceptible individuals can cause hypersensitivity pneumonitis, considered a prevalent entity among diffuse interstitial lung diseases. A radical change in the classification of this undervalued entity has recently been proposed. In this report we describe the clinical and radiological characteristics of three cases of fibrotic hypersensitivity pneumonitis: bird keeper's lung, feather pillow lung, and chemical alveolitis. A table is shown with the probable occupations or risk exposures in our environment and an updated review of the subject is carried out.

References

Solaymani-Dodaran M, West J, Smith C, Hubbard R. Extrinsic allergic alveolitis: incidence and mortality in the general population, QJM: An International Journal of Medicine 2007;100(4):233–237, 10.1093/qjmed/hcm008

Raghu G, Remi-Jardin M, Ryerson CJ, Myers JL, Kreuter M, Vasakova M, et al. Diagnosis of Hypersensitivity Pneumonitis in Adults: An Official ATS/JRS/ALAT Clinical Practice Guideline. Am J RespirCrit Care Med. 2020;202(3):e36–e69. 10.1164/rccm.202005-2032ST

Pereira CA, Giménez A, Kuranishi L, Storrer K. Chronic hypersensitivity pneumonitis. Journal of asthma and allergy 2016;9:171–181. 10.2147/JAA.S81540

Sosa OD, Rolón PA, Pérez de Troche S. Neumonitis por hipersensibilidad al aserrín de lapacho, cedro, petereby y ybyrapytá. Anales de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción 1982; XIV (1-2); 199-210.

Hamblin M, Prosch H, Vašáková M. Diagnosis, course and management of hypersensitivity pneumonitis. EurRespir Rev. 2022;31(163):210169. 10.1183/16000617.0169-2021

Nogueira R, Melo N, Novais EB, N. Martins N, Delgado L, Morais A, et al. Hypersensitivity pneumonitis: Antigen diversity and disease implications. Pulmonology. 2019;25(2):97-108. 10.1016/j.pulmoe.2018.07.003

Fernández Pérez ER, Travis WD, Lynch DA, Brown KK, Johansson KA, Selman M, et al. Diagnosis and Evaluation of Hypersensitivity Pneumonitis: CHEST Guideline and Expert Panel Report. Chest. 2021;160(2):e97-e156. 10.1016/j.chest.2021.03.066

Lynch DA, Newell J, Logan P, King T, Muller NL. Can CT distinguish hypersensitivity pneumonitis from idiopathic pulmonary fibrosis? AJR. Am. J. Roentgenol. 1995;165:807–811. 10.2214/ajr.165.4.7676971

Silva CIS, Muller N, Lynch DA, David A. Lynch, Curran-Everett D, Brown KK, Lee KS, et al. Chronic hypersensitivity pneumonitis: Differentiation from idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia by using thin-section CT. Radiology. 2008;246:288–297. 10.1148/radiol.2453061881

Dabiri M, Jehangir M, Khoshpouri P, Chalian H. Hypersensitivity Pneumonitis: A Pictorial Review Based on the New ATS/JRS/ALAT Clinical Practice Guideline for Radiologists and Pulmonologists. Diagnostics(Basel). 2022;12(11):2874. 10.3390/diagnostics12112874

Cosgrove GP, Bianchi P, Danese S, Lederer D. Barriers to timely diagnosis of interstitial lung disease in the real world: the INTENSITY survey. BMC Pulm Med. 2018;18(1):9. 10.1186/s12890-017-0560-x

Seixas E, Ferreira M, Serra P, Aguiar R, Cunha I, Ferreira PG. Criteria for progressive fibrotic hypersensitivity pneumonitis in a Portuguese patient cohort. Afr J Thoracic Crit Care Med 2022;28(4):163-166. 10.7196/AJTCCM.2022.v28i4.250

Olson AL, Huie TJ, Groshong SD, Schwarz MI, Brown KK, Frankel SK, et al. Acute exacerbations of fibrotic hypersensitivity pneumonitis: a case series. Chest. 2008;134(4):844–850. 10.1378/chest.08-0428

Creamer AW, Barratt SL. Prognostic factors in chronic hypersensitivity pneumonitis. Eur Respir Rev. 2020;29:190167 10.1183/16000617.0167-2019

Oliveira RKF, Pereira CAC, Ramos RP, Ferreira EVM, Messina CMS, Kuranishi LT, et al7. A haemodynamic study of pulmonary hypertension in chronic hypersensitivity pneumonitis. Eur Respir J 2014;44:415–424. 10.1183/09031936.00010414

Oliveira RKF, Ota-Arakaki JS, Gomes PS, Gimenez A, Messina CMS, Ramos Roberta P, et al. Pulmonary haemodynamics and mortality in chronic hypersensitivity pneumonitis. EurRespir J. 2018;51(6):1800430. 10.1183/13993003.00430-2018

Alberti ML, Rincon-Alvarez E, Buendia-Roldan I, Selman M. Hipersensitivity Pneumonitis: Diagnostic and Therapeutic Challenges. Front Med (Lausanne). 2021, 23;8:718299. 10.3389/fmed.2021.718299

Published

2023-06-29

How to Cite

1.
Pérez Bejarano D. Fibrotic hypersensitivity pneumonitis: case report and proposal of sources of exposure in our environment. Rev. cient. cienc. salud [Internet]. 2023 Jun. 29 [cited 2024 Dec. 25];5:01-9. Available from: https://upacifico.edu.py:8043/index.php/PublicacionesUP_Salud/article/view/361