Hypersensitivity Pneumonitis Induced by Spores of Lyophyllum aggregatum

Tsushima, Kenji; Yamazaki, Yoshitaka; Takamizawa, Akemi; Amari, Toshiya; Koizumi, Tomonobu; Kubo, Keishi

doi:10.1378/chest.120.4.1085

Cited by 19 publications

(24 citation statements)

References 16 publications

(15 reference statements)

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“…The spores of Maitake are 3 to 7 m in size, therefore they can reach the alveoli and potentially cause HP. The latent period was very short, 3 months, in this case, and previous reports for other spores described latent times varying from 2 months to 48 years (1)(2)(3)(4)(5). We previously reported that 71.4% of mushroom workers experienced an allergic chronic cough within 3 months after starting work in a Bunashimeji mushroom farm (8).…”

Section: Discussionsupporting

confidence: 63%

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Successful Treatment of Hypersensitivity Pneumonitis Caused by Grifola frondosa (Maitake) Mushroom Using a HFA-BDP Extra-fine Aerosol

et al. 2004

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We successfully treated a patient with occupational hypersensitivity pneumonitis (HP) caused by Grifola frondosa (Maitake) mushroom spore with an extra-fine aerosol corticosteroid; beclomethasone dipropionate (BDP) dissolved in hydrofluoroalkane-134a (HFA). A 49-year-old woman developed respiratory symptoms 3 months after beginning work on a mushroom farm. She was diagnosed as HP based on radiological and serological findings. Oral prednisolone therapy improved her HP and she returned to the same farm. Her HP relapsed after 5 months, and daily 400 g of HFA-BDP was administered with gradual improvement. An extra-fine particle inhaled corticosteroid might reach appropriate alveoli to be effective therapy for mild HP.

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Section: Discussionsupporting

confidence: 63%

“…There are several recent reports of hypersensitivity pneumonitis (HP) induced by inhaled mushroom spores (1)(2)(3)(4)(5), and mushroom farms carry a significant risk for HP. The principle treatment for HP is avoidance of causative antigens and systemic steroids.…”

Section: Introductionmentioning

confidence: 99%

Successful Treatment of Hypersensitivity Pneumonitis Caused by Grifola frondosa (Maitake) Mushroom Using a HFA-BDP Extra-fine Aerosol

et al. 2004

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“…Ta-ble 1 details and reviews several species and antigens which have not been previously reported as causal agents of MWL [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25]. Of note is the case report of HP in a 61-year-old Japanese man [7] who was exposed for 12 years to Shiitake mushrooms and then developed an adenosquamous carcinoma lesion (stage 1B) in his left lung.…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity Pneumonitis Associated with Mushroom Worker’s Lung: An Update on the Clinical Significance of the Importation of Exotic Mushroom Varieties

Moore

Convery²,

Millar

et al. 2005

Int Arch Allergy Immunol

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Hypersensitivity pneumonitis remains an important industrial disease in mushroom workers. It has a significant morbidity, and early diagnosis and removal from exposure to the antigen are critically important in its management. Recently, several new allergens have been described, particularly those from mushroom species originating in the Far East, which are of clinical significance to workers occupationally exposed to such allergens in cultivation, picking, and packing of commercial mushroom crops. Importing of exotic mushrooms including Shiitake is common in EU countries, and some of the exotic species of mushrooms are cultivated for local markets. This practice may contribute to an increase in clinical cases of mushroom hypersensitivity pneumonitis. This update reviews the recent literature and examines changing trends of mushroom worker’s lung, with increased movement of commercial product and labour markets worldwide.

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“…The criteria [1] used to establish the diagnosis of Bunashimeji-mushroom-related HP included the following: clinical features associated with ground glass opacity and small nodules on high-resolution CT (HRCT), predominance of lymphocytes in BAL fluid, alveolitis with infiltrating lymphocytes and histological granuloma formation in the alveoli, a positive precipitating assay due to Bunashimeji spores and/or positive SI levels (>200%) due to Bunashimeji spores determined at the Special Reference Laboratory. …”

Section: Methodsmentioning

confidence: 99%

“…Some people who work in the Bunashimeji industry suffer from hypersensitivity pneumonitis (HP) due to chronic inhalation of Bunashimeji mushroom spores. We have previously reported the clinical features and diagnostic methods of HP induced by Lyophyllum aggregatum spores [1]. Tanaka et al [2] reported 2 cases of HP due to mushroom spores of H. marmoreus .…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity Pneumonitis due to Bunashimeji Mushrooms in the Mushroom Industry

Tsushima¹,

Yoshikawa²,

Kawakami

et al. 2005

Int Arch Allergy Immunol

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Background: Detection of hypersensitivity pneumonitis (HP) in employees involved in the Bunashimeji mushroom industry is difficult. The level of precipitating antibody is not related with the prediction of progression and resolution of HP. The aims of this study were to examine the actual prevalence of HP in the Bunashimeji industry and the clinical differences among selected employees. Methods: One hundred and fourteen employees worked in Bunashimeji enterprises. These subjects were divided into the following subgroups: office workers, pickers/packers with mask and pickers/packers without mask. We measured serum Krebs von der Lungen-6 (KL-6), surfactant protein (SP)-A and SP-D, and examined the stimulation index (SI) due to Bunashimeji spores. Chest high-resolution computed tomography (HRCT), pulmonary function tests and bronchoalveolar lavage (BAL) were performed for select employees who showed positive SI values (>200%) to examine the clinical differences. Results: The proportion of respiratory symptoms was significantly higher in the pickers/packers than that in the office workers. The picker/packer group had high serum KL-6 concentrations and SI compared with the office worker group. Thirty select employees were divided into the following three subgroups: HP, select employees without HP, and SI <400% and KL-6 <500 U/ml , using high SI levels (>400%) and positive serum KL-6 concentration (>500 U/ml). Four exhibited ground glass opacities with centrilobular fine nodules on HRCT, and 8 had high numbers of lymphocytes in the BAL fluid. The BAL findings and serum KL-6 concentrations showed significant differences among the three groups. Conclusions: Four employees were evaluated as having HP. Serum KL-6 and SP-D may be related to the resolution of HP in addition to SI and chest HRCT.

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Hypersensitivity Pneumonitis Induced by Spores of Lyophyllum aggregatum

Cited by 19 publications

References 16 publications

Successful Treatment of Hypersensitivity Pneumonitis Caused by Grifola frondosa (Maitake) Mushroom Using a HFA-BDP Extra-fine Aerosol

Successful Treatment of Hypersensitivity Pneumonitis Caused by Grifola frondosa (Maitake) Mushroom Using a HFA-BDP Extra-fine Aerosol

Hypersensitivity Pneumonitis Associated with Mushroom Worker’s Lung: An Update on the Clinical Significance of the Importation of Exotic Mushroom Varieties

Hypersensitivity Pneumonitis due to Bunashimeji Mushrooms in the Mushroom Industry

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