Hypersensitivity Pneumonitis and Extrinsic Asthma

Karr, Reynold At.; Bartall, Haim; Köhler, Peter F.; Selvaggio, John E.

doi:10.1378/chest.74.1.98

Cited by 16 publications

(6 citation statements)

References 5 publications

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“…Asthma has rarely been reported in patients at the time of the diagnosis of FL [1,3,29,30], but, according to the present study and an earlier study by CUTHBERT and GORDON [31], asthma seems to not be uncommon years after suffering from FL.…”

Section: Discussionsupporting

confidence: 59%

Long-term outcome of pulmonary function in farmer's lung: a 14 year follow-up with matched controls

Erkinjuntti-Pekkanen

Kokkarinen²,

Tukiainen³

et al. 1997

Eur Respir J

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The long-term outcome of pulmonary function was evaluated in farmer's lung (FL) patients compared to representative control farmers. This is, to our knowledge, the first such study which has included a control group. Clinical examinations were conducted in 89 FL patients and 84 control farmers, matched by age, sex, and smoking habits. The mean time after the first diagnosed episode of FL was 14 yrs.The mean transfer factor of the lung for carbon monoxide (TL,CO) was on average 12% lower (p<0.001) in FL patients compared to control farmers. In spirometry, the mean maximum expiratory flow at 50% of vital capacity (MEF50) was lower (p=0.08) in FL patients but there were no differences in mean vital capacity (VC) or forced expiratory volume in one second (FEV1) between FL patients and control farmers. However, airway obstruction, defined as an FEV1/VC less than 88% of predicted, was more common in FL patients than in control farmers (33 versus 17%; p=0.02). Patients who had had recurrent episodes of FL had a significantly lower mean TL,CO compared to those FL patients who had experienced only a single episode.In conclusion, impairment of the pulmonary transfer factor is the most important long-term consequence of farmer's lung. However, farmer's lung may also lead to development of airway obstruction.

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Section: Discussionsupporting

confidence: 59%

Long-term outcome of pulmonary function in farmer's lung: a 14 year follow-up with matched controls

Erkinjuntti-Pekkanen

Kokkarinen²,

Tukiainen³

et al. 1997

Eur Respir J

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“…Karr and his coworkers have reported a case with concomitant development of asthma and farmer's lung (8).…”

Section: Discussionmentioning

confidence: 99%

Asthma in patients with farmer's lung during a five-year follow-up

Kokkarinen

H²,

Terho³

1997

Scand J Work Environ Health

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Objectives This study assessed the incidence of asthma in patients with farmer's lung. Methods The study population consisted of 103 1 patients who had occupational fanner's lung diagnosed from 1983 to 1988. The cases of farmer's lung were registered in the nationwide Register of Occupational Diseases by the Finnish Institute of Occupational Health, and all the patients in the study had received compensation from the insurance company for an occupational disease. The diagnosis of asthma was based on entitlement to a special refund for asthma medication costs from the national sickness insurance program. Results Seventy-four cases of asthma were found among farmers with farmer's lung up to the end of the 5 years following the year of the diagnosis for farmer's lung. The prevalence of asthma was 1 % in the year preceding the diagnosis. In the year of the diagnosis and during the 5 years of follow-up, asthma was diagnosed in an additional 6% of the patients. C O~C~U S~O~~S The results of this study confirm previous findings of a low prevalence of asthma before the onset of farmer's lung in small groups of patients. However, the results also indicate that the incidence of asthma increases during the first years after an episode of farmers lung. For example, in the present study, asthma was apparent in 7% of the patients 5 years after the diagnosis of farmer's lung.

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“…A search of relevant literature produces only very few cases in which the combina tion of hypersensitivity pneumonitis with severe airway obstruction can be clearly demonstrated; these were patients sensi tized to farm field dust [6], aspergilli [10], or bird excrement [5,9].…”

Section: Discussionmentioning

confidence: 99%

Hypersensitivity Pneumonitis Concomitant with Acute Airway Obstruction after Exposure to Hay Dust

Baur¹,

Dexheimer²

1984

Respiration

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The case of a non-atopic farmer who had developed severe respiratory as well as systemic symptoms upon exposure to hay dust during the past several years is presented. Inhalation challenge by his own hay induced an unusual association of peripheral and central airway obstruction beginning immediately, and hardly susceptible to therapeutic control, as well as the typical hypersensitivity pneumonitis reaction several hours later. By means of double immunodiffusion it was possible to demonstrate serum precipitins to antigenic components in this hay, which could be predominantly identified as antigens of several Aspergillus species. By means of the more sensitive crossed immunoelectrophoresis technique ten relevant antigens of Aspergillus terreus and four of Aspergillus fumigatus were demonstrable. Only minimal aspergillus-specific IgE antibodies were found in the patient’s serum. This case demonstrates that hay dust can cause bronchial obstruction as well as hypersensitivity pneumonitis in the same individual, with symptoms beginning immediately and lasting up to 2 days

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Hypersensitivity Pneumonitis and Extrinsic Asthma

Cited by 16 publications

References 5 publications

Long-term outcome of pulmonary function in farmer's lung: a 14 year follow-up with matched controls

Long-term outcome of pulmonary function in farmer's lung: a 14 year follow-up with matched controls

Asthma in patients with farmer's lung during a five-year follow-up

Hypersensitivity Pneumonitis Concomitant with Acute Airway Obstruction after Exposure to Hay Dust

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