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Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis

A 77-year-old man was initially diagnosed with idiopathic pulmonary fibrosis (IPF) and treated with anti-fibrotic nintedanib. Despite undergoing anti-fibrotic treatment for one year, his condition remained unstable. The patient was admitted to our hospital for exertional dyspnea. We performed an exp...

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Autores principales: Ito, Yasuhiro, Miwa, Seiichi, Hayakawa, Hiroshi, Oshima, Tomoko, Eihuku, Tatsuru, Iwaizumi, Eriko, Ohba, Hisano, Fujita, Kaoru, Kanai, Miho, Shirai, Masahiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483807/
https://www.ncbi.nlm.nih.gov/pubmed/36133420
http://dx.doi.org/10.1016/j.rmcr.2022.101737
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author Ito, Yasuhiro
Miwa, Seiichi
Hayakawa, Hiroshi
Oshima, Tomoko
Eihuku, Tatsuru
Iwaizumi, Eriko
Ohba, Hisano
Fujita, Kaoru
Kanai, Miho
Shirai, Masahiro
author_facet Ito, Yasuhiro
Miwa, Seiichi
Hayakawa, Hiroshi
Oshima, Tomoko
Eihuku, Tatsuru
Iwaizumi, Eriko
Ohba, Hisano
Fujita, Kaoru
Kanai, Miho
Shirai, Masahiro
author_sort Ito, Yasuhiro
collection PubMed
description A 77-year-old man was initially diagnosed with idiopathic pulmonary fibrosis (IPF) and treated with anti-fibrotic nintedanib. Despite undergoing anti-fibrotic treatment for one year, his condition remained unstable. The patient was admitted to our hospital for exertional dyspnea. We performed an exposure assessment, including 2-week antigen avoidance and an environmental inhalation challenge, and successfully re-diagnosed him with fibrotic hypersensitivity pneumonitis (HP), known as chronic farmer's lung. Adding oral glucocorticoids to the nintedanib treatment improved his condition. Although antigen avoidance and environmental inhalation challenge tests are not standardized, they may be useful for diagnosing fibrotic HP when properly applied.
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spelling pubmed-94838072022-09-20 Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis Ito, Yasuhiro Miwa, Seiichi Hayakawa, Hiroshi Oshima, Tomoko Eihuku, Tatsuru Iwaizumi, Eriko Ohba, Hisano Fujita, Kaoru Kanai, Miho Shirai, Masahiro Respir Med Case Rep Case Report A 77-year-old man was initially diagnosed with idiopathic pulmonary fibrosis (IPF) and treated with anti-fibrotic nintedanib. Despite undergoing anti-fibrotic treatment for one year, his condition remained unstable. The patient was admitted to our hospital for exertional dyspnea. We performed an exposure assessment, including 2-week antigen avoidance and an environmental inhalation challenge, and successfully re-diagnosed him with fibrotic hypersensitivity pneumonitis (HP), known as chronic farmer's lung. Adding oral glucocorticoids to the nintedanib treatment improved his condition. Although antigen avoidance and environmental inhalation challenge tests are not standardized, they may be useful for diagnosing fibrotic HP when properly applied. Elsevier 2022-09-13 /pmc/articles/PMC9483807/ /pubmed/36133420 http://dx.doi.org/10.1016/j.rmcr.2022.101737 Text en © 2022 The Authors https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Ito, Yasuhiro
Miwa, Seiichi
Hayakawa, Hiroshi
Oshima, Tomoko
Eihuku, Tatsuru
Iwaizumi, Eriko
Ohba, Hisano
Fujita, Kaoru
Kanai, Miho
Shirai, Masahiro
Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
title Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
title_full Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
title_fullStr Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
title_full_unstemmed Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
title_short Antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
title_sort antigen avoidance and environmental inhalation challenge for successful diagnosis of fibrotic hypersensitivity pneumonitis mimicking idiopathic pulmonary fibrosis
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9483807/
https://www.ncbi.nlm.nih.gov/pubmed/36133420
http://dx.doi.org/10.1016/j.rmcr.2022.101737
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