Pulmonary function and fitness years after treatment for hypersensitivity pneumonitis during childhood

2015 ◽  
Vol 51 (8) ◽  
pp. 830-837 ◽  
Author(s):  
Yagmur Sisman ◽  
Frederik Buchvald ◽  
Anne Katrine Blyme ◽  
Jann Mortensen ◽  
Kim Gjerum Nielsen
Keyword(s):  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis

scholarly journals A new type of Hypersensitivity Pneumonitis: salami brusher’s disease

2015 ◽  
Vol 77 (1) ◽  
Author(s):  
M. Marvisi ◽  
L. Balzarini ◽  
C. Mancini ◽  
P. Mouzakiti
Keyword(s):  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis ◽  
Community Acquired Pneumonia ◽  
Prick Test ◽  
White Mould ◽  
Clinical Onset ◽  
Oral Steroids ◽  
Radiological Pattern ◽  
New Type ◽  
Penicillium Spp

We observed five consecutive cases of Hypersensitivity Pneumonitis in subjects working in a salami factory. The workers had to clean the white mould growing on salami surface using a manual wire brush. The five patients (four female) had a mean age of 39±15 years; two were smokers. Three patients had an acute clinical presentation with fever, dyspnoea, dry cough, oxygen desaturation, and presented at the emergency department with suspected diagnosis of community acquired pneumonia. The mean latency for developing respiratory symptoms was 11.6 days. Pulmonary function test demonstrated a reduction in diffusing capacity (DLCO) in all 5 patients (60±15% of predicted value). Skin prick test was positive for Penicillium spp in 3 cases and for Cladosporium and Aspergillus spp in 2 others. Specific IgG antibodies against Penicillium spp were positive in 3 subjects; 2 were positive for Aspergillus Fumigatus. The prevailing radiological pattern was a ground glass appearance in the three patients with acute clinical onset and a centrilobular one in patients with subacute onset. All patients were advised to avoid exposure to the antigens. Follow-up visits including pulmonary function testing, and DLCO measurement were conducted at one, three and six months. HRCT was performed at six month. Four subjects had a complete radiological and clinical resolution after changing work. Only one patient was treated with oral steroids for severe dyspnoea and progressive reduction of DLCO, gaining a complete radiological and clinical stability at six months.

scholarly journals Serum CXCL9 and CCL17 as biomarkers of declining pulmonary function in chronic bird-related hypersensitivity pneumonitis

PLoS ONE ◽  
2019 ◽  
Vol 14 (8) ◽  
pp. e0220462 ◽  
Author(s):  
Yoshihisa Nukui ◽  
Takashi Yamana ◽  
Masahiro Masuo ◽  
Tomoya Tateishi ◽  
Mitsuhiro Kishino ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis

scholarly journals The Efficacy of Corticosteroid Therapy in Fibrotic Hypersensitivity Pneumonitis: A Propensity Score-matched Cohort Analysis

2020 ◽  
Author(s):  
Masaru Ejima ◽  
Tsukasa Okamoto ◽  
Takafumi Suzuki ◽  
Tatsuhiko Anzai ◽  
Kunihiko Takahashi ◽  
...  
Keyword(s):  
Survival Rate ◽  
Propensity Score ◽  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis ◽  
Proportional Hazards Model ◽  
Cohort Analysis ◽  
Corticosteroid Treatment ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Propensity Score Method

Abstract Background: Fibrotic hypersensitivity pneumonitis (HP) is a chronic interstitial lung disease caused by allergic responses to repeated exposures to a causative antigen. Therapeutic evidence of corticosteroid for fibrotic HP remains lacking, although corticosteroid is recognized as a major treatment option. The purpose of this study was to evaluate the efficacy of corticosteroid for patients with fibrotic HP in a propensity score-matched cohort.Methods: Retrospective medical record review from 2005 to 2019 in a single center was conducted to identify 144 patients with fibrotic HP. Semiquantitative scores of lung abnormalities on HRCT were evaluated. Patients with corticosteroid treatment (PDN group) and without the treatment (non-PDN group) were matched using a propensity score method. Survival rates and serial changes in pulmonary function, and annual changes in HRCT scores werecompared between pair-matched patients. Results: In the matched analysis, 30 of the PDN group were matched with 30 of the non-PDN group, the majority of which comprised ILD without extensive fibrosis. The survival rate was significantly better in the PDN group (P = 0.032for the stratified Cox proportional hazards model; HR, 0.250). Absolute changes in %FVC at 6, 12, and 24 months from baseline were significantly better in the PDN group. Fewer cases experienced annual deterioration in HRCT scores in the non-PDN group for ground-glass attenuation, consolidation, reticulation, traction bronchiectasis and honeycombing. Conclusions: Fibrotic HP without extensive fibrosis may receive benefits from corticosteroid treatment in terms of improvements in survival rate and pulmonary function decline and inhibition of fibrotic progression. We propose that early initiation of corticosteroid be considered for fibrotic HP when worsening fibrosis is observed.

Pulmonary function trends predict mortality in patients with hypersensitivity pneumonitis

2018 ◽  
Author(s):  
Cristina Boccabella ◽  
Claudio Macaluso ◽  
Maria Kokosi ◽  
Veronica Alfieri ◽  
Carmel Stock ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis

scholarly journals Use Of Leflunomide In Patients With Hypersensitivity Pneumonitis

2020 ◽  
Author(s):  
Sungryong Noh ◽  
Ruchi Yadav ◽  
Manshi Li ◽  
Xiaofeng Wang ◽  
Debasis Sahoo ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Lung Function ◽  
Adverse Effects ◽  
Pulmonary Function ◽  
Hypersensitivity Pneumonitis ◽  
Second Line ◽  
Significant Fibrosis ◽  
Discontinue Therapy ◽  
Sparing Effect ◽  
Steroid Sparing

Abstract Prednisone has been shown to reverse lung function declines in hypersensitivity pneumonitis patients without established fibrosis. Second line immunosuppressants like azathioprine and mycophenolate mofetil have a steroid sparing effect and improve DLCO. There is no published literature on the use of leflunomide in such patients. We reviewed our experience with leflunomide for treatment of hypersensitivity pneumonitis in 40 patients. We stratified patients according to the presence or absence of significant (>20%) fibrosis. We studied the effect of leflunomide on FVC and DLCO trajectory and reported the changes at 12 months.Treatment with leflunomide tended to improve the estimated FVC slope from 0.18±1.90% (SEM) of predicted per year to 4.62±1.65% of predicted (NS, p=0.118). It significantly improved the FVC at 12 months of treatment by 4.4% of predicted (p=0.02). DLCO continued to increase at 1.45±1.44% (SEM) of predicted per year. Non-fibrotic HP patients had the largest gain in pulmonary function. Their FVC increased by 8.3% (p=0.001) and DLCO by 4.8% (p=0.011). Patients with fibrotic HP did not improve. Leflunomide treatment was associated with significant gastrointestinal and other adverse effects leading 40% of patients to discontinue therapy. It had a significant steroid sparing effect with half the patients weaned off prednisone entirely.Leflunomide appears to be a fairly well tolerated steroid sparing immunosuppressant that improves pulmonary function in HP patients. It is most effective in patients without significant fibrosis.

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