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 P54 KIDS-STEP: a swiss multi-centre RCT on effectiveness of adjunct betamethasone therapy in hospitalised children with community acquired pneumonia

2019 ◽  
Vol 104 (6) ◽  
pp. e39.2-e39
Author(s):  
M Kohns Vasconcelos ◽  
R Santoro ◽  
M Coslovsky ◽  
J van den Anker ◽  
JA Bielicki
Keyword(s):  
Hospital Discharge ◽  
Community Acquired Pneumonia ◽  
High Rate ◽  
Oral Steroid ◽  
List Type ◽  
Serious Adverse Events ◽  
Adjunct Treatment ◽  
Oral Steroids ◽  
Meta Analyses ◽  
Clinical Stability

BackgroundThe incidence of community-acquired pneumonia (CAP) in young children is high (20- 30/1000 child-years) and is associated with a high rate of hospitalisation (around 10/1000 child-years). In adults, a benefit of adjunct corticosteroids on time to clinical stability and hospital discharge has been observed and confirmed in systematic reviews and meta-analyses. In contrast, only few small trials have addressed the potential impact of oral steroid treatment in CAP during childhood. The purpose of this study is to concurrently evaluate whether adjunct treatment with corticosteroids in children hospitalised with CAP is more effective in terms of the proportion of children reaching clinical stability and whether such adjunct treatment is no worse in terms of CAP relapse.MethodsChildren in KIDS-STEP1 receive either oral betamethasone or oral placebo dosed once daily for two consecutive days. We include 700 children from age 1 weighing at least 7 kilograms and up to a body weight of 35 kilograms and age below 10 years hospitalised for CAP using a clinical diagnosis.Co-primary outcomes are(a) The proportion of children clinically stable at 48 hours after randomisation. (b) The proportion of children with CAP-related readmission within 28 days after randomization. Secondary outcomes will be captured to further evaluate the efficacy and safety of adjunct oral steroids in the management of childhood CAP, including proportion of children experiencing solicited side effects of the trial treatment and/or serious adverse events, time to hospital discharge after index hospitalisation in days, time away from routine child care and away from work (for parents) in days up to 28 days after randomisation and total antibiotic exposure in days up to 28 days after randomisation.ResultsEnrolment started in November 2018 and is currently proceeding at approximately 1 participant per participating hospital per week.ReferencesStudy registration: BASEC - EKNZ 2018–00563Disclosure(s)Nothing to disclose

scholarly journals 281. Hypersensitivity Pneumonitis Diagnosed with Broad-Range PCR Testing after Exposure to Battarrea Mushroom Spores

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S153-S154
Author(s):  
Laura Selby ◽  
Justin D Jacobs ◽  
Adam C Brady
Keyword(s):  
Emergency Department ◽  
Hypersensitivity Pneumonitis ◽  
Supplemental Oxygen ◽  
Community Acquired Pneumonia ◽  
Molecular Testing ◽  
Methamphetamine Use ◽  
Routine Work ◽  
Oral Corticosteroids ◽  
History Of ◽  
Primer Sets

Abstract Background Battarrea puffball mushrooms are found extensively worldwide and contain spore-containing sacs. Inhalation of the spores of similar mushrooms, such as Lycoperdon, have been implicated in cases of lycoperdonosis—a syndrome of hypersensitivity pneumonitis. We report a case of hypersensitivity pneumonitis confirmed to be secondary to Battarrea spore exposure diagnosed by broad-range PCR. Methods A 23-year-old homeless man with a history of methamphetamine use presented to the emergency department with a 2-week history of fevers, chills, productive cough, and malaise. He reported his symptoms began soon after eating a long-stemmed mushroom he found growing next to a building. He reported inhaling particles from the mushroom when he picked it up prior to eating it. He vomited within 1 hour of ingestion, and then had a worsening progression of cough and malaise over the following 2 weeks. In the emergency department, he was noted to have leukocytosis and mild elevation of transaminases. He required supplemental oxygen due to hypoxemia. CT scan of his chest demonstrated extensive bilateral nodular pulmonary infiltrates. He was admitted and started on treatment for community-acquired pneumonia. Over the next several days, he had worsening respiratory failure, and routine work up for infectious etiologies was unrevealing. To further investigate, bronchoscopy and bronchoalveolar lavage (BAL) was performed and routine bacterial, fungal and mycobacterial cultures and cytology with Gomori Methanamine-silver and acid-fast stains were negative. BAL fluid was sent for broad range DNA testing by PCR. Antibiotic therapy was stopped, and he was started on steroids to treat presumed hypersensitivity pneumonitis. He recovered rapidly and was discharged on a course of oral corticosteroids. Results After the patient was discharged, molecular testing of BAL fluid resulted with detection of Battarrea species DNA using 28s and ITS primer sets. DNA from no other pathogens was detected. Conclusion Identified through broad range DNA PCR testing, exposure to Battarrea mushroom spores may be a previously unreported cause of hypersensitivity pneumonitis. PCR testing should be considered in the workup of hypersensitivity pneumonitis with known or suspected exposure to mushroom spores. Disclosures All authors: No reported disclosures.

scholarly journals Heightened bronchial hyperresponsiveness in the absence of heightened atopy in children with current wheezing and low-income status.

Thorax ◽  
2007 ◽  
Author(s):  
Javier Mallol ◽  
Jose A. Castro-Rodriguez ◽  
Eliana Cortez ◽  
Viviana Aguirre ◽  
Pedro Aguilar ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Low Income ◽  
Challenge Test ◽  
Bronchial Hyperresponsiveness ◽  
Significant Risk ◽  
Prick Test ◽  
Income Status ◽  
Random Samples ◽  
Significant Difference ◽  
The Relationship

Background: Although global studies as ISAAC have provided with valuable data on the prevalence of asthma in children of Latin America, there is very few information on the relationship between asthma symptoms, pulmonary function, bronchial hyperresponsiveness and atopy in the region. Methods: This study examined the relationship between self-reported wheezing in the last 12 months, pulmonary function, airway responsiveness and atopy in children from a low-income population neighborhood in Santiago, Chile. Two random samples (100 each) of children aged 13-14 years who participated in ISAAC Phase One were selected according to whether they have reported or not, wheezing in the last 12 months. Spirometry, methacholine bronchial challenge test and prick test were performed in all individuals. Results: Children who reported current wheezing had significantly higher bronchial hyperresponsiveness (BHR) to methacholine as compared to those without wheezing (71.6% vs.52.6%, respectively; p=0.007,) and no significant difference was found in FEV1 (116.7„b12.3% vs. 120.3„b14.5%, respectively, p=0.11). The prevalence of atopy was not significantly different between those children who reported wheezing as compared to those who did not (44.2% vs. 42.3%; respectively, p=0.89). Multiple regression analysis showed that only BHR to methacholine (OR 2.72, 95% CI: 1.25-4.13, p=0.01) and maternal asthma (OR 3.1, 95%CI 1.2-8.3, p=0.03) were significant risk factors for current wheezing. Conclusions: Our results support previous findings suggesting that in adolescents from unprivileged populations, self-reported current wheezing is related to BHR but not to atopy.

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

559 Changes in pulmonary function after skin prick test with latex protein extracts

1996 ◽  
Vol 97 (1) ◽  
pp. 322-322 ◽  
Author(s):  
B MAGERA ◽  
K KELLY ◽  
J FINK ◽  
T SULLIVAN ◽  
L GEHRING ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Skin Prick Test ◽  
Prick Test

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
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