Hypersensitivity pneumonitis: <scp>A</scp> protean and challenging disease

Jee, Adelle S.; Jo, Helen; Corte, Tamera J.

doi:10.1111/resp.13158

Cited by 3 publications

(2 citation statements)

References 14 publications

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“…Jee et al [25] stated that strong correlation of PVV with the extent of interstitial lung disease but not with right ventricular systolic pressure was suggesting that PVV may reflect interstitial damage rather than pulmonary hypertension severity, and hence might pro-vide an additional measure of disease severity not quantifiable on visual assessment.…”

Section: Discussionmentioning

confidence: 99%

Pulmonary vessel volume can help to differentiate fibrotic lung diseases

GÖKÇEK

2023

The European Research Journal

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Objectives: Idiopathic pulmonary fibrosis (IPF), non-specific interstitial pneumonia (NSIP), and chronic hypersensitivity pneumonitis (CHP) are diffuse fibrosing lung diseases that are sometimes difficult to differentiate by only visual evaluation of CT images. We aimed to find if pulmonary vessel volume (PVV), a new quantitative CT measure, can help to differentiate these diseases at the time of diagnosis. Methods: We retrospectively measured PVV values of IPF, NSIP, and CHP patients diagnosed within the last five years in our institution, by using their CT images at the time of diagnosis. We used CALIPER-technology (Computer-Aided Lung Informatics for Pathology Evaluation and Rating) for the quantification of CT images. We compared the PVV values of disease groups by the Kruskal-Wallis test and performed ROC curve analysis to evaluate the ability of PVV to differentiate these diseases. Results: We measured the PVV values of 152 patients, 113 of them were diagnosed with IPF, 16 with NSIP, and 23 with CHP. The PVV value of the NSIP group was significantly lower than that of both IPF (p = 0.028) and CHP (p = 0.013) groups. However, there was no significant difference between IPF and CHP groups (p = 0.924). Selected cut-off values of PVV were found to differentiate NSIP from IPF with a specificity of 88%, and NSIP from CHP with a specificity of 91%. Conclusions: PVV measured by CALIPER at the time of diagnosis can help to differentiate NSIP from both IPF and CHP.

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Section: Discussionmentioning

confidence: 99%

Pulmonary vessel volume can help to differentiate fibrotic lung diseases

GÖKÇEK

2023

The European Research Journal

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“…Hypersensitivity pneumonitis (HP) is an immunologically-mediated inflammatory lung disease caused by repetitive inhalation of antigens in a susceptible host [1–3]. Potential causative agents are grouped as microbes, animal proteins, and chemicals [1, 4, 5]. Bird related HP is becoming the commonest form caused by high- and low-molecular-weight proteins found in feathers, faeces, and other animal products commonly of pigeons, parrots, parakeets, love birds, cockatoos, budgerigars, and fowl [4, 6–8].…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity Pneumonitis Associated with Red-Vented Bulbul: A New Encounter of Bird Related Hypersensitivity Pneumonitis

Amarasinghe¹,

Jayasekara²,

Jayamanne

et al. 2019

Case Reports in Pulmonology

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Bird related hypersensitivity pneumonitis (HP) is becoming more common than other forms of HP around the world. We present two cases of HP, associated with exposure to visiting birds which had nested within their homes in semi urban areas of Colombo, Sri Lanka. A 65-year-old female (case 1) and a 61-year-old male (case 2) presented to the chest clinic complaining of gradually progressive and persistent chronic dry cough and dyspnoea during the year 2018. Both were found to have close contact with red-vented bulbuls (Konda kurulla) in their homes for more than 6 months prior to onset of symptoms and denied any other risk exposures in detail history taking. In both patients, high-resolution computed tomography chest (HRCT) showed centrilobular nodules of ground glass density with significant lobular air trapping. Video-assisted thoracoscopic (VATs) lung biopsy of case 1 showed patchy and focal interstitial thickening with lymphocytic infiltrate, minimal fibrosis, and few noncaseating granulomata within the interstitium. Transbronchial lung biopsy of case 2 showed thickened alveolar septae with lympho-histiocytic infiltrate and occasional neutrophils and eosinopils. Both showed severe reduction in forced vital capacity (FVC) at presentation. Multidisciplinary diagnosis of HP associated with red-vented bulbuls was made. Both achieved good improvement in clinical, lung function, and radiological assessment following removal of offending antigen exposure and treatment with oral corticosteroids.

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Recurrent Pulmonary Embolism and Hypersensitivity Pneumonitis Secondary to Aspergillus, in a Compost Plant Worker: Case Report and Review of Literature

Lal

Akhtar

Pinto

et al. 2018

Lung

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Activation of blood coagulation pathways as a component of an allergic response has been studied in animal models. In patients with allergic diseases, clot qualities have been noted to be different in terms of denser fibrin clot with reduced plasmin-mediated clot lysis. Correlation between occupational hypersensitivity pneumonitis (HP) with thromboembolic events is scarce in the general patient population. We present a case of a 52-year-old man with recurrent venous thromboembolism with HP secondary to bioaerosol exposure in a compost plant. Biochemical evaluation found no evidence of underlying hypercoagulable state, with only remarkable findings of elevated levels of total serum immunoglobulin E and raised Aspergillus sp. IgG antibodies. The patient decided to change his working environment to one without exposure to compost or other fungal elements. His symptoms and pulmonary function tests gradually improved without any subsequent intervention. The patient chose against the advice of his care providers to discontinue warfarin anti-coagulation that had been recommended for lifelong duration after recurrent pulmonary thromboembolism. At a 4-year follow-up he has remained free of any further episodes of venous thromboembolic events without any anti-coagulation. Repeated imaging studies after cessation of exposure demonstrated clearance of multiple lung nodules and improvement in DLco.

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Hypersensitivity pneumonitis: A protean and challenging disease

Abstract: http://onlinelibrary.wiley.com/doi/10.1111/resp.13122/abstract

Cited by 3 publications

References 14 publications

Pulmonary vessel volume can help to differentiate fibrotic lung diseases

Pulmonary vessel volume can help to differentiate fibrotic lung diseases

Hypersensitivity Pneumonitis Associated with Red-Vented Bulbul: A New Encounter of Bird Related Hypersensitivity Pneumonitis

Recurrent Pulmonary Embolism and Hypersensitivity Pneumonitis Secondary to Aspergillus, in a Compost Plant Worker: Case Report and Review of Literature

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