• Title/Summary/Keyword: Hypersensitivity pneumonitis

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The first case of summer-type hypersensitivity pneumonitis in Korea (Trichosporon cutaneum에 의한 summer-type hypersensitivity pneumonitis 1예)

  • Lee, Seung-Joon;Kim, Gye-Soo;Lee, Jae-Cheol;Yoo, Churl-Gyoo;Kim, Young-Whan;Han, Sung-Koo;Shim, Y.
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.280-284
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    • 1996
  • We report the first case of summer-type hypersensitivity pneumonitis(SHP) in Korea diagnosed by positive serum antibodies to Trichosporon cutaneum. Hypersensitivity pneumonitis(HP) has been commonly classified as an occupational respiratory diseases. However, evidence that sensitizing organisms can also contaminate and cause pulmonary diseases in home environment has been increasing. One such disease is SHP. In Japan, 75% of cases with HP are SHP. Even though there has been no known SHP case in Korea yet, there has been high possibility of SHPs in Korea because our country has areas which have hot and humid summer climate similar to Japan. This first case of SHP in Korea suggests that there may be another cases in Korea and nation-wide survey may be required. We report here the first confirmed case of SHP in Korea.

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A Case of Hypersensitivity Pneumonitis by Alternaria as a Suspected Etiology (Alternaria가 원인으로 추정되는 과민성 폐장염 1예)

  • Do, Yun Kyung;Kim, Yeon Jae;Kang, Hyun Jae;Yu, Kyung Sul;Yun, Hae Jin;Jun, Jae Hyun;Lee, Byung Ki;Song, Do Young
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.338-345
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    • 2003
  • A 65-year-old man was admitted due to low grade fever, dry coughing, and dyspnea on exertion. The chest radiograph and CT scan showed diffuse ground glass opacities and small nodules in the both lung fields resulting in a diagnosis of severe interstitial pneumonia. Conservative treatment with antibiotics and bronchodilators decreased the symptoms, but the dyspnea and cough reappeared when he returned home. An inspection of his house revealed the presence of fungi under the wallpaper. His symptoms disappeared completely after these were removed. His clinical course raised the suspicion of hypersensitivity pneumonitis and these fungi believed to be the cause of hypersensitivity pneumonitis. The histological findings of a lung specimen by video-assisted thorachoscopy were compatible with hypersensitivity pneumonitis. The fungi were identified as Alternaria.

Current Diagnosis and Management of Hypersensitivity Pneumonitis

  • Leone, Paolo Maria;Richeldi, Luca
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.122-131
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    • 2020
  • Hypersensitivity Pneumonitis (HP) one of the most common interstitial lung diseases (ILDs) is characterized by exposure to an inhaled inciting antigen that leads to a host immunologic reaction determining interstitial inflammation and architectural distortion. The underlying pathogenetic mechanisms are unclear. The absence of international shared diagnostic guidelines and the lack of a "gold-standard" test for HP combined with the presence of several clinical and radiologic overlapping features makes it particularly challenging to differentiate HP from other ILDs, also in expert contests. Radiology is playing a more crucial role in this process; recently the headcheese sign was recognized as a more specific for chronic-HP than the extensive mosaic attenuation. Several classification proposals and diagnostic models have been advanced by different groups, with no prospective validation. Therapeutic options for HP have been limited to antigen avoidance and immunosuppressant drugs over the last decades. Several questions about this condition remain unanswered and there is a need for more studies.

A Case of Gold Induced Hypersensitivity Pneumonitis Diagnosed by Lymphocyte Stimulation Test with Gold (림프구 자극 시험으로 확진된 금제에 의한 과민성폐렴 1예)

  • Yum, Ho-Kee;Han, Seong-Hoon;Kim, Hyung-Gon;Lee, Hye-Kyung;Jeon, Woo-Ki;Lee, Yun-Woo;Kim, Dong-Soon
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.5
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    • pp.546-551
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    • 1994
  • Gold therapy of rheumatoid arthritis is effective, but adverse reactions are also common. There are some cutaneous, hematologic, renal, and pulmonary side effects which have been associated with immunologic abnormalities. Also, hypersensitivity pneumonitis induced by gold therapy was rarely reported in literature. But, the mechanism for the induction of the pulmonary disease is not known. We report a case of seropositive rheumatoid arthritis presented as gold induced hypersensitivity pneumonitis which was confirmed by the peripheral blood lymphocyte stimulation test with gold.

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Risk Assessment for Metalworking Fluids and Respiratory Outcomes

  • Park, Robert M.
    • Safety and Health at Work
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    • v.10 no.4
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    • pp.428-436
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    • 2019
  • Background: Metalworking fluids (MWFs) are mixtures with inhalation exposures as mists, dusts, and vapors, and dermal exposure in the dispersed and bulk liquid phase. A quantitative risk assessment was performed for exposure to MWF and respiratory disease. Methods: Risks associated with MWF were derived from published studies and NIOSH Health Hazard Evaluations, and lifetime risks were calculated. The outcomes analyzed included adult onset asthma, hypersensitivity pneumonitis, pulmonary function impairment, and reported symptoms. Incidence rates were compiled or estimated, and annual proportional loss of respiratory capacity was derived from cross-sectional assessments. Results: A strong healthy worker survivor effect was present. New-onset asthma and hypersensitivity pneumonitis, at 0.1 mg/㎥ MWF under continuous outbreak conditions, had a lifetime risk of 45%; if the associated microbiological conditions occur with only 5% prevalence, then the lifetime risk would be about 3%. At 0.1 mg/㎥, the estimate of excess lifetime risk of attributable pulmonary impairment was 0.25%, which may have been underestimated by a factor of 5 or more by a strong healthy worker survivor effect. The symptom prevalence associated with respiratory impairment at 0.1 mg/㎥ MWF was estimated to be 5% (published studies) and 21% (Health Hazard Evaluations). Conclusion: Significant risks of impairment and chronic disease occurred at 0.1 mg/㎥ for MWFs in use mostly before 2000. Evolving MWFs contain new ingredients with uncharacterized long-term hazards.

A Case of Hypersensitivity Pneumonitis in an Automobile Paint Sprayer (자동차 페인트 도장공에서 발생한 과민성 폐렴 1예)

  • Oh, Mi Na;Cho, Myoung Jin;Baek, Hoon Ki;Cho, Ki Sung;Kang, Ji Hoon;Kim, Young;Kwak, Jin Young
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.6
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    • pp.541-545
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    • 2008
  • Hypersensitivity pneumonitis (HP) is an immunologically-mediated disease resulting from repeated exposure to sensitizing agents, such as organic dusts or chemicals. Isocyanate is a volatile and highly reactive chemical that is extensively used in the manufacturing of automobiles, upholstery, and polyurethane foam. Occupational respiratory diseases associated with isocyanate, such as bronchial asthma, are well-known. It is thought that HP is one of the rare diseases induced by isocyanate with a very low frequency worldwide. We report a case of HP in an automobile painting sprayer which appeared to be associated with isocyanate.

A Case of Hypersensitivity Pneumonitis Following Placenta Extract Injection (태반 추출물 주사 후 발생한 과민성 폐장염 1예)

  • Lee, Sang Seok;Choo, Young Kwang;Bang, Chang Seok;Kim, Youn Seup;Park, Jae Seuk;Jee, Young Koo;Kim, Doh Hyung;Myong, Na Hye
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.471-476
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    • 2009
  • Human placenta contains various kinds of nutritional elements essential for embryonic development. Currently, human placenta extracts are widely overused in Korea to improve certain health conditions (postmenopausal syndrome, liver function, and cosmetic purposes) without scientific evidence that they actually work. The use of placenta extracts should be restricted, due to a lack of systematic research on the therapeutic effectiveness and adverse results from these treatments. While the common adverse effects that have been reported are fever, rash, itching, nausea, vomiting, breast pain, and rare cases of anaphylactic shock, there have been no reports of pulmonary complications such as hypersensitivity pneumonitis. Recently, we experienced a patient with hypersensitivity pneumonitis following a placenta extract injection. To our knowledge, this is the first case of hypersensitivity pneumonitis associated with placenta extract use.

Review of Humidifier Lung Cases Caused by Use of Humidifier - Focusing on Probable Environmental Causal Agents - (가습기 폐질환(Humidifier Lung)의 환경적 원인 인자 고찰)

  • Park, Donguk
    • Journal of Environmental Health Sciences
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    • v.39 no.2
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    • pp.105-116
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    • 2013
  • Background: In Korea, there is low awareness of the respiratory health problems caused by the use of humidifiers, leading to a lack of governmental measures. Objectives: The objectives of this study were to review cases of varying degrees of humidifier lung and fever in connection with the use of humidifiers and to summarize the probable environmental agents causing these cases. Methods: We searched all articles reporting on humidifier lung, humidifier fever, and humidifier diseases caused by the use of a humidifier both at home and in the workplace. Results: We summarized a number of cases of varying degrees of respiratory diseases resulting from inhalation of water mist of humidifiers containing various species of bacteria and fungi and their toxins. Type of respiratory disease connected with humidifier lung includes interstitial pneumonitis, hypersensitivity pneumonitis, fever and several respiratory symptoms. Non-tuberculous mycobacteria (NTM), Actinomycetes, endotoxins and contaminated humidifier water were the most commonly suspected probable environmental agents causing humidifier lung. In Korea, the use of humidifier biocide is suspected as a likely cause of fatal lung injury including death and lung transplantation. Conclusion: Governmental policy should be devised and measures including a national surveillance system should be taken to prevent humidifier lung caused by the use of humidifiers.

Fcγ Receptors Modulate Pulmonary Inflammation by Activating Innate Immune Cells in Murine Hypersensitivity Pneumonitis

  • Park, Hyo Jin;Kim, Hye Sung;Chung, Doo Hyun
    • IMMUNE NETWORK
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    • v.10 no.1
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    • pp.26-34
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    • 2010
  • Background: Hypersensitivity pneumonitis (HP) is an interstitial lung disease that develops following repeated exposure to inhaled particulate antigens. The family of $Fc{\gamma}$ receptors ($Fc{\gamma}Rs$) has emerged as central regulators for modulating both pro-and anti-inflammatory responses. However, the role of $Fc{\gamma}Rs$ in the development of HP has not been investigated yet. Methods: To explore the functional roles of $Fc{\gamma}Rs$ in HP, $Fc{\gamma}R^{-/-}$ and B6 mice were challenged with Saccharopolyspora rectivirgula (SR) antigen intranasally, and compared these mice in terms of the histological change, infiltrated immune cells in BALF and in vitro immune responses. Results: $Fc{\gamma}R^{-/-}$ mice exhibited attenuation of HP in terms of histological alterations, and reduced numbers of neutrophils and macrophages in and the increased CD4 : CD8 ratio of bronchoalveolar lavage fluid. The lungs of $Fc{\gamma}R^{-/-}$ mice showed high production of Th2 cytokine such as IL-4 and slightly low production of Th1 cytokine, INF-${\gamma}$ compared to those of B6 mice. However, SR-specific adaptive immune responses of $Fc{\gamma}R^{-/-}$ mice were similar to those of B6 mice. Conclusion: These results demonstrate that activating $Fc{\gamma}$ receptors play an important role in activating neutrophils and macrophages in pulmonary inflammation and inducing Th1 differentiation by regulating cytokine expression in SR-induced HP.