Hypersensitivity pneumonitis from ordinary residential exposures.

Abstract

A previously healthy woman developed hypersensitivity pneumonitis of such severity that she required chronic systemic corticosteroid therapy for symptom control. Detailed investigation of her workplace and home environments revealed fungi in her typical suburban home, to which she had specific serum precipitating antibodies. Efforts to remove mold from the home were unsuccessful in relieving symptoms, and moving to another residence was the only intervention that allowed her to be withdrawn from corticosteroid therapy. Hypersensitivity pneumonitis is commonly associated with occupational or avocational exposures, such as moldy hay in farmers or bird antigen in bird breeders. We propose that hypersensitivity pneumonitis may occur in North America, as it does in Japan, from domestic exposures alone.

Respiratory Morbidity and Medical Visits Associated with Dampness and Air-conditioning in Offices and Homes

“…Symptoms of chills, fever, malaise, muscle achiness, cough, headache, and dyspnea are classically present. Case reports and a literature review of hypersensitivity pneumonitis due to home and building fungal exposure have been reported in the scientific literature (Apostolakos et al., 2001; Kreiss and Hodgson, 1984; Lee et al., 2000; Thörn et al., 1996). We identified an association between home dampness and constitutional symptoms which served to raise our level of suspicion that some of the participants may have had hypersensitivity pneumonitis.…”

Of microbes and men

“…In moldy houses, the disease is too rare to be detected in epidemiological studies. However, individual cases or clusters of non‐agricultural mold‐related hypersensitivity pneumonitis (Apostolakos et al., 2001; Trout et al., 2001) as well as pulmonary hemorrhage in infants (Flappan et al., 1999; Montaña et al., 1995) have been described. While these cases have been related to mold exposures in specific situations, the exact causative agents remain to be identified.…”

Hypersensitivity Pneumonitis Associated with Environmental Mycobacteria

“…Persistent disease can cause permanent loss of lung function and even death. Many patients develop disease from exposures associated with work, although exposure to biologic aerosols from home can also cause disease (Apostolakos et al 2001; Kawai et al 1984; Wright et al 1999). …”