- Second Hypersensitivity Pneumonitis in the Same Patient Caused by Chinchillas. [Journal Article]
- JIJ Investig Allergol Clin Immunol 2018; 28(6):441-442
- Long-term outcomes in chronic hypersensitivity pneumonitis. [Journal Article]
- AAllergy 2018 Dec 04
- CONCLUSIONS: CHP is a severe disease with a bad mid-term prognosis. Lymphocyte values in BAL and DLCO values at baseline, presence of honeycomb in HRCT and UIP histologic pattern were found to be predictors of survival. Early accurate diagnosis of the disease is fundamental for prompt initiation of antigen avoidance. This article is protected by copyright. All rights reserved.
- [Causes of mediastinal/hilar granulomatous lymphadenitis]. [Journal Article]
- TTTuberk Toraks 2018; 66(3):212-216
- CONCLUSIONS: In this study, we found that the most common cause of granulomatous lymphadenitis was sarcoidosis. Contrary to expectations, the number of patients diagnosed with tuberculosis was very low.
- Interstitial Lung Disease and Pulmonary Fibrosis: A Practical Approach for General Medicine Physicians with Focus on the Medical History. [Review]
- JCJ Clin Med 2018 Nov 24; 7(12)
- Interstitial lung disease (ILD) and pulmonary fibrosis comprise a wide array of inflammatory and fibrotic lung diseases which are often confusing to general medicine and pulmonary physicians alike. I...
Interstitial lung disease (ILD) and pulmonary fibrosis comprise a wide array of inflammatory and fibrotic lung diseases which are often confusing to general medicine and pulmonary physicians alike. In addition to the myriad of clinical and radiologic nomenclature used in ILD, histopathologic descriptors may be particularly confusing, and are often extrapolated to radiologic imaging patterns which may further add to the confusion. We propose that rather than focusing on precise histologic findings, focus should be on identifying an accurate etiology of ILD through a comprehensive and detailed medical history. Histopathologic patterns from lung biopsy should not be dismissed, but are often nonspecific, and overall treatment strategy and prognosis are likely to be determined more by the specific etiology of ILD rather than any particular histologic pattern. In this review, we outline a practical approach to common ILDs, highlight important aspects in obtaining an exposure history, clarify terminology and nomenclature, and discuss six common subgroups of ILD likely to be encountered by general medicine physicians in the inpatient or outpatient setting: Smoking-related, hypersensitivity pneumonitis, connective tissue disease-related, occupation-related, medication-induced, and idiopathic pulmonary fibrosis. Accurate diagnosis of these forms of ILD does require supplementing the medical history with results of the physical examination, autoimmune serologic testing, and chest radiographic imaging, but the importance of a comprehensive environmental, avocational, occupational, and medication-use history cannot be overstated and is likely the single most important factor responsible for achieving the best possible outcomes for patients.
- [Features distinguishing ornithosis from avian acute hypersensitivity pneumonitis - a retrospective analysis]. [Journal Article]
- RMRev Mal Respir 2018 Nov 22
- CONCLUSIONS: Our results suggest that patients with ornithosis and HP have important differences in their clinical, biological, and radiological presentation.
- Hypersensitivity pneumonitis and its correlation with ambient air pollution in urban India. [Letter]
- EREur Respir J 2018 Nov 21
- Hypersensitivity Pneumonitis: A Fibrosing Alveolitis Produced by Inhalation of Diverse Antigens. [Journal Article]
- JAJ Allergy Clin Immunol 2018 Nov 15
- Hypersensitivity pneumonitis (HP) is a TH1 lymphocyte biased fibrosing alveolitis that is caused by antigens ranging from avian excreta, fungi, thermophilic bacteria, and protozoa to reactive chemica...
Hypersensitivity pneumonitis (HP) is a TH1 lymphocyte biased fibrosing alveolitis that is caused by antigens ranging from avian excreta, fungi, thermophilic bacteria, and protozoa to reactive chemicals found in the workplace. Mimicking a viral syndrome, acute exposures to inciting antigens cause abrupt onset of non-productive cough, dyspnea, chills, with arthralgias or malaise usually from 4-8 hours later so that the temporal relationship between antigen exposure and symptoms may be unsuspected. The histology of HP reveals prominent lymphocyte infiltrates that thicken the alveolar septa with poorly formed granulomas or giant cells. Broncholalveolar lavage demonstrates > 20% lymphocytes in nearly all patients. Abnormalities on high resolution computerized tomography examinations range from nodular, centrilobular opacities in acute/subacute disease to increased reticular markings and honeycombing fibrosis, which typically are predominant in the upper lobes, in advanced disease. Descriptors include "mosaic attenuation" and "ground-glass" opacities. Repeated episodes can result in nodular pulmonary infiltrates and suspected nonspecific interstitial pneumonia or idiopathic pulmonary fibrosis. Clinicians require a high level of suspicion to make an early diagnosis of HP before extensive pulmonary fibrosis or restrictive lung disease has occurred.
- A Rare Pediatric Case of Severe Bird Fancier's Lung Presented with Viral Pneumonitis-Like Picture. [Case Reports]
- CChildren (Basel) 2018 Nov 12; 5(11)
- Bird Fancier's Lung (BFL) is a rare, nonatopic immunologic response to repeated or intense inhalation of avian (bird) proteins/antigens found in the feathers or droppings of many species of birds, wh...
Bird Fancier's Lung (BFL) is a rare, nonatopic immunologic response to repeated or intense inhalation of avian (bird) proteins/antigens found in the feathers or droppings of many species of birds, which leads to an immune-mediated inflammatory reaction in the respiratory system. Although this is the most common type of hypersensitivity pneumonitis (HP) reported in adults, it is one of the classifications of a rare subtype of interstitial lung disease that occurs in the pediatric age group of which few case reports are available in the literature. The pathophysiology of HP is complex; numerous organic and inorganic antigens can cause immune dysregulation, leading to an immune-related antigen⁻antibody response (immunoglobulin G-IgG- against the offending antigen). Diagnosing BFL in the pediatric age group is challenging due to the history of exposure usually being missed by health care providers, symptoms and clinical findings in such cases being nonspecific and often misdiagnosed during the acute illness with other common diseases such asthma or acute viral lower respiratory tract infection, and the lack of standardization of criteria for diagnosing such a condition or sensitive radiological or laboratory tests. Treatment, on the other hand, is also controversial. Avoidance of the offending antigen could be the sole or most important part of treatment, particularly in acute mild and moderate cases. Untreated cases can result in irreversible lung fibrosis. In this case report, we highlight how children presenting with an acute viral lower respiratory tract infection can overlap with the acute/subacute phase of HP. Early intervention with pulse steroids markedly improves the patient's clinical course.
- Serum AGE/RAGEs as potential biomarker in idiopathic pulmonary fibrosis. [Journal Article]
- RRRespir Res 2018 Nov 08; 19(1):215
- CONCLUSIONS: These findings demonstrate that the increase of AGE/sRAGE ratio is higher in IPF, although the levels were close to cHP. AGE/sRAGE increase correlates with respiratory functional progression. Furthermore, the concentration of sRAGE in blood stream at diagnosis and follow-up could be considered as a potential prognostic biomarker.
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- Disseminated varicella-zoster virus infection with abdominal pain possibly caused by pirfenidone: A case report. [Journal Article]
- RMRespir Med Case Rep 2018; 25:330-332
- We report a case of chronic hypersensitivity pneumonitis treated with pirfenidone in a 76-year-old woman who complained of acute-onset abdominal pain and rashes. The patient was diagnosed with dissem...
We report a case of chronic hypersensitivity pneumonitis treated with pirfenidone in a 76-year-old woman who complained of acute-onset abdominal pain and rashes. The patient was diagnosed with disseminated varicella-zoster virus (VZV) infection, and pirfenidone was discontinued. Her condition improved in one month. Pirfenidone may induce disseminated VZV infection.