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Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration

A 79-year-old man was admitted with worsening cough, dyspnea, and increased ground-glass opacity on chest computed tomography (CT). He had been diagnosed with idiopathic pulmonary fibrosis given the absence of an identifiable cause of interstitial pneumonia, chest CT findings, and absence of lymphoc...

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Autores principales: Moda, Mitsuhiro, Arai, Toru, Takeuchi, Naoko, Kagawa, Tomoko, Takimoto, Takayuki, Sumikawa, Hiromitsu, Shimizu, Shigeki, Inoue, Yoshikazu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017243/
https://www.ncbi.nlm.nih.gov/pubmed/35871594
http://dx.doi.org/10.2169/internalmedicine.9736-22
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author Moda, Mitsuhiro
Arai, Toru
Takeuchi, Naoko
Kagawa, Tomoko
Takimoto, Takayuki
Sumikawa, Hiromitsu
Shimizu, Shigeki
Inoue, Yoshikazu
author_facet Moda, Mitsuhiro
Arai, Toru
Takeuchi, Naoko
Kagawa, Tomoko
Takimoto, Takayuki
Sumikawa, Hiromitsu
Shimizu, Shigeki
Inoue, Yoshikazu
author_sort Moda, Mitsuhiro
collection PubMed
description A 79-year-old man was admitted with worsening cough, dyspnea, and increased ground-glass opacity on chest computed tomography (CT). He had been diagnosed with idiopathic pulmonary fibrosis given the absence of an identifiable cause of interstitial pneumonia, chest CT findings, and absence of lymphocytosis in bronchoalveolar lavage (BAL) fluid. Meticulous history taking revealed extensive exposure to inciting antigens contained in chicken fertilizer before symptom worsening. A re-evaluation with BAL showed lymphocytosis, and clinical improvement with antigen avoidance confirmed the diagnosis of fibrotic hypersensitivity pneumonitis (fHP). A re-evaluation with BAL at disease deterioration after possible exposure to inciting antigen can facilitate a correct fHP diagnosis.
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spelling pubmed-100172432023-03-16 Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration Moda, Mitsuhiro Arai, Toru Takeuchi, Naoko Kagawa, Tomoko Takimoto, Takayuki Sumikawa, Hiromitsu Shimizu, Shigeki Inoue, Yoshikazu Intern Med Case Report A 79-year-old man was admitted with worsening cough, dyspnea, and increased ground-glass opacity on chest computed tomography (CT). He had been diagnosed with idiopathic pulmonary fibrosis given the absence of an identifiable cause of interstitial pneumonia, chest CT findings, and absence of lymphocytosis in bronchoalveolar lavage (BAL) fluid. Meticulous history taking revealed extensive exposure to inciting antigens contained in chicken fertilizer before symptom worsening. A re-evaluation with BAL showed lymphocytosis, and clinical improvement with antigen avoidance confirmed the diagnosis of fibrotic hypersensitivity pneumonitis (fHP). A re-evaluation with BAL at disease deterioration after possible exposure to inciting antigen can facilitate a correct fHP diagnosis. The Japanese Society of Internal Medicine 2022-07-22 2023-02-15 /pmc/articles/PMC10017243/ /pubmed/35871594 http://dx.doi.org/10.2169/internalmedicine.9736-22 Text en Copyright © 2023 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Moda, Mitsuhiro
Arai, Toru
Takeuchi, Naoko
Kagawa, Tomoko
Takimoto, Takayuki
Sumikawa, Hiromitsu
Shimizu, Shigeki
Inoue, Yoshikazu
Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration
title Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration
title_full Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration
title_fullStr Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration
title_full_unstemmed Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration
title_short Fibrotic Hypersensitivity Pneumonitis Diagnosed by a Re-evaluation with Bronchoalveolar Lavage at Disease Deterioration
title_sort fibrotic hypersensitivity pneumonitis diagnosed by a re-evaluation with bronchoalveolar lavage at disease deterioration
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10017243/
https://www.ncbi.nlm.nih.gov/pubmed/35871594
http://dx.doi.org/10.2169/internalmedicine.9736-22
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