Home About us Contact
|
Home About us Contact | ||
|
|
||
Hypersensitivity Pneumonitis (hypersensitivity + pneumonitis)
Selected AbstractsHypersensitivity pneumonitis caused by triglycidyl isocyanurateALLERGY, Issue 10 2004S. Quirce No abstract is available for this article. [source] Hypersensitivity pneumonitis caused by Penicillium citrinum, not enoki sporesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2007Sumiko Yoshikawa MD Abstract Background Flammulina velutipes is called the Enoki mushroom in Japanese and is cultivated indoors. Mushroom workers face occupational exposure to a tremendous number of fungi and organic antigens capable of causing hypersensitivity pneumonitis (HP). One worker employed at an Enoki farm developed HP due to Penicillium citrinum. This study investigated new cases of HP among the workers cultivating Enoki. Methods Serum Krebs von der Lungen-6 (KL-6), surfactant protein (SP)-A and SP-D were measured. Lymphocyte stimulation tests (LST) and double immunodiffusion tests (DIT) were performed to identify P. citrinum. Workers showing high levels of KL-6, SP-A, or SP-D and a high LST value or positive DIT were identified and then were further examined by chest computed tomography, bronchoalveolar lavage and transbronchial lung biopsy. The initial patient and new HP patients were defined as the HP group and the other participants were defined as the non-HP group. Results Forty-eight Enoki workers participated in the study. Four of nine workers who met the criteria for further examinations were diagnosed as having HP due to P. citrinum. In comparison between non-HP group and HP group, KL-6, SP-D and LST values were significantly higher in HP group. There was a strong correlation between KL-6 and SP-D. DIT had high sensitivity and high specificity. Conclusions KL-6, SP-D, LST, and DIT were useful for detecting HP patients. KL-6 was the most useful predictor of HP in this study. DIT was useful not only as a predictor of HP but also as a detector of the causative antigen. Am. J. Ind. Med. 50:1010,1017, 2007. © 2007 Wiley-Liss, Inc. [source] Hypersensitivity pneumonitis due to metal working fluids: Sporadic or under reported?AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2006Amit Gupta MD Abstract Background Occupational exposure to metal working fluids (MWF) is common with over 1.2 million workers in the United States involved in machine finishing, machine tooling, and other metalworking operations. MWF is a known cause of hypersensitivity pneumonitis (HP). Recent reports of outbreaks of hypersensitivity HP secondary to exposure to MWF are reported. Design Cases were identified through the Occupational Disease surveillance system in the State of Michigan and from referrals for evaluation to the Division of Occupational and Environmental Medicine at Michigan State University (MSU). Each patient underwent a clinical examination including an occupational history, lung function studies, radiographic imaging, and in some cases lung biopsies. Following the diagnosis of definite HP, an industrial hygiene investigation was carried out, which included a plant walk-through, and review of the "Injury and Illness" log. Air monitoring and microbial sampling results were reviewed. Results As part of Michigan's mandatory surveillance system for occupational illnesses, seven cases of suspected HP were identified in 2003,2004 from three facilities manufacturing automobile parts in Michigan. Each plant used semi-synthetic MWFs, and conducted a MWF management program including biocide additions. Two facilities had recently changed the MWF before the cases arose. Growth of mycobacteria was found in these two MWFs. Breathing zone samples for particulates of two employees in plant A (two cases) ranged from 0.48 to 0.56 mg/m3. In plant B (four cases), two employees' sampling results ranged from 0.10 to 0.14 mg/m3. No air sampling data were available from plant C. Conclusion Hypersensitivity pneumonitis due to exposure to MWFs is under-recognized by health care providers, and current surveillance systems are inadequate to provide a true estimate of its occurrence. HP arose from environments with exposures well below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for MWF, and in one case from exposures well below the National Institute of Occupational Safety and Health (NIOSH) recommended exposure limit (REL). The sporadic nature of reports of HP in relationship to MWF probably represents a combination of workplace changes that cause the disease and inadequate recognition and reporting of the disease when it does occur. Physician awareness of HP secondary to MWF and an effective medical surveillance program are necessary to better understanding the epidemiology and prevention of this disease. Am. J. Ind. Med. 2006. © 2006 Wiley-Liss, Inc. [source] Exposure to methyl methacrylate and hypersensitivity pneumonitis in dental techniciansALLERGY, Issue 8 2004A. Scherpereel No abstract is available for this article. [source] Spectrum of Fibrosing Diffuse Parenchymal Lung DiseaseMOUNT SINAI JOURNAL OF MEDICINE: A JOURNAL OF PERSONALIZED AND TRANSLATIONAL MEDICINE, Issue 1 2009Adam S. Morgenthau MD Abstract The interstitial lung diseases are a heterogeneous group of disorders characterized by inflammation and/or fibrosis of the pulmonary interstitium. In 2002, the American Thoracic Society and the European Respiratory Society revised the classification of interstitial lung diseases and introduced the term diffuse parenchymal lung disease. The idiopathic interstitial pneumonias are a subtype of diffuse parenchymal lung disease. The idiopathic interstitial pneumonias are subdivided into usual interstitial pneumonia (with its clinical counterpart idiopathic interstitial pneumonia), nonspecific interstitial pneumonia, cryptogenic organizing pneumonia, acute interstitial pneumonia, desquamative interstitial pneumonia, respiratory bronchiolitis interstitial lung disease, and lymphocytic pneumonia. Sarcoidosis and hypersensitivity pneumonitis are the 2 most common granulomatous diffuse parenchymal lung diseases. Rheumatoid arthritis, systemic sclerosis, and dermatomyositis/polymyositis (causing antisynthetase syndrome) are diffuse parenchymal lung diseases of known association because these conditions are associated with connective tissue disease. Hermansky-Pudlak syndrome is a rare genetic diffuse parenchymal lung disease characterized by the clinical triad of pulmonary disease, oculocutaneous albinism, and bleeding diathesis. This review provides an overview of the chronic fibrosing diffuse parenchymal lung diseases. Its primary objective is to illuminate the clinical challenges encountered by clinicians who manage the diffuse parenchymal lung diseases regularly and to offer potential solutions to those challenges. Treatment for the diffuse parenchymal lung diseases is limited, and for many patients with end-stage disease, lung transplantation remains the best option. Although much has been learned about the diffuse parenchymal lung diseases during the past decade, research in these diseases is urgently needed. Mt Sinai J Med 76:2,23, © 2009 Mount Sinai School of Medicine [source] Hypersensitivity pneumonitis caused by Penicillium citrinum, not enoki sporesAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2007Sumiko Yoshikawa MD Abstract Background Flammulina velutipes is called the Enoki mushroom in Japanese and is cultivated indoors. Mushroom workers face occupational exposure to a tremendous number of fungi and organic antigens capable of causing hypersensitivity pneumonitis (HP). One worker employed at an Enoki farm developed HP due to Penicillium citrinum. This study investigated new cases of HP among the workers cultivating Enoki. Methods Serum Krebs von der Lungen-6 (KL-6), surfactant protein (SP)-A and SP-D were measured. Lymphocyte stimulation tests (LST) and double immunodiffusion tests (DIT) were performed to identify P. citrinum. Workers showing high levels of KL-6, SP-A, or SP-D and a high LST value or positive DIT were identified and then were further examined by chest computed tomography, bronchoalveolar lavage and transbronchial lung biopsy. The initial patient and new HP patients were defined as the HP group and the other participants were defined as the non-HP group. Results Forty-eight Enoki workers participated in the study. Four of nine workers who met the criteria for further examinations were diagnosed as having HP due to P. citrinum. In comparison between non-HP group and HP group, KL-6, SP-D and LST values were significantly higher in HP group. There was a strong correlation between KL-6 and SP-D. DIT had high sensitivity and high specificity. Conclusions KL-6, SP-D, LST, and DIT were useful for detecting HP patients. KL-6 was the most useful predictor of HP in this study. DIT was useful not only as a predictor of HP but also as a detector of the causative antigen. Am. J. Ind. Med. 50:1010,1017, 2007. © 2007 Wiley-Liss, Inc. [source] Twenty-three years of hypersensitivity pneumonitis mortality surveillance in the United States,,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 12 2006Ki Moon Bang PhD Abstract Background There are few population-based studies addressing hypersensitivity pneumonitis (HP) in the United States. The National Institute for Occupational Safety and Health (NIOSH) has nationally comprehensive longitudinal mortality data that can contribute to a better understanding of the epidemiology of HP. Methods The National Center for Health Statistics multiple cause-of-death data were analyzed for the period 1980,2002. Annual death rate was age-adjusted to the 2000 U.S. standard population. Death rate time-trends were calculated using a linear regression model and geographic distribution of death rates were mapped by state and county. Proportionate mortality ratios (PMRs) by usual industry and occupation adjusted for age, sex, and race, were based on data from 26 states reporting industry and occupation during 1985,1999. Results Overall age-adjusted death rates increased significantly (P,<,0.0001) between 1980 and 2002, from 0.09 to 0.29 per million. Wisconsin had the highest rate at 1.04 per million. Among industries, PMR for HP was significantly high for agricultural production, livestock (PMR, 19.3; 95% CI, 14.0,25.9) and agricultural production, crops (PMR, 4.3; 95% CI, 3.0,6.0). Among occupations, PMR for HP was significantly elevated for farmers, except horticulture (PMR, 8.1; 95% CI, 6.4,10.2). Conclusions These findings indicate that agricultural industries are closely associated with HP mortality and preventive strategies are needed to protect workers in these industries. Am. J. Ind. Med. 2006. © 2006 Wiley-Liss, Inc. [source] Hypersensitivity pneumonitis due to metal working fluids: Sporadic or under reported?AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 6 2006Amit Gupta MD Abstract Background Occupational exposure to metal working fluids (MWF) is common with over 1.2 million workers in the United States involved in machine finishing, machine tooling, and other metalworking operations. MWF is a known cause of hypersensitivity pneumonitis (HP). Recent reports of outbreaks of hypersensitivity HP secondary to exposure to MWF are reported. Design Cases were identified through the Occupational Disease surveillance system in the State of Michigan and from referrals for evaluation to the Division of Occupational and Environmental Medicine at Michigan State University (MSU). Each patient underwent a clinical examination including an occupational history, lung function studies, radiographic imaging, and in some cases lung biopsies. Following the diagnosis of definite HP, an industrial hygiene investigation was carried out, which included a plant walk-through, and review of the "Injury and Illness" log. Air monitoring and microbial sampling results were reviewed. Results As part of Michigan's mandatory surveillance system for occupational illnesses, seven cases of suspected HP were identified in 2003,2004 from three facilities manufacturing automobile parts in Michigan. Each plant used semi-synthetic MWFs, and conducted a MWF management program including biocide additions. Two facilities had recently changed the MWF before the cases arose. Growth of mycobacteria was found in these two MWFs. Breathing zone samples for particulates of two employees in plant A (two cases) ranged from 0.48 to 0.56 mg/m3. In plant B (four cases), two employees' sampling results ranged from 0.10 to 0.14 mg/m3. No air sampling data were available from plant C. Conclusion Hypersensitivity pneumonitis due to exposure to MWFs is under-recognized by health care providers, and current surveillance systems are inadequate to provide a true estimate of its occurrence. HP arose from environments with exposures well below the Occupational Safety and Health Administration (OSHA) permissible exposure limit (PEL) for MWF, and in one case from exposures well below the National Institute of Occupational Safety and Health (NIOSH) recommended exposure limit (REL). The sporadic nature of reports of HP in relationship to MWF probably represents a combination of workplace changes that cause the disease and inadequate recognition and reporting of the disease when it does occur. Physician awareness of HP secondary to MWF and an effective medical surveillance program are necessary to better understanding the epidemiology and prevention of this disease. Am. J. Ind. Med. 2006. © 2006 Wiley-Liss, Inc. [source] Elevated alveolar nitric oxide concentration after environmental challenge in hypersensitivity pneumonitisRESPIROLOGY, Issue 4 2010Toshihiro SHIRAI ABSTRACT We describe a 57-year-old male patient admitted to hospital with hypersensitivity pneumonitis (HP) that resolved without treatment. The total and alveolar nitric oxide (NO) concentrations were measured on initial admission and after re-exposure to his home environment. Following environmental exposure he became ill again, alveolar NO concentration was increased to the same level as on initial admission and impaired pulmonary function and radiologic abnormalities were found. It suggested a diagnosis of environmentally induced HP. The clinical value of measuring alveolar NO as an acute-phase reactant in HP is demonstrated in this patient. [source] Clinicopathological features of chronic hypersensitivity pneumonitisRESPIROLOGY, Issue 4 2002HIROSHI HAYAKAWA Objective: Only limited information exists concerning the clinical and pathological features of chronic hypersensitivity pneumonitis (HP) in Japan and elsewhere. We present data on clinicopathological features of chronic HP obtained through a Japanese nationwide survey. Methodology: We studied the clinical and pathological findings in 10 patients with chronic HP who underwent surgical lung biopsy or postmortem examination. Results: There were three types of clinical course: six of the 10 patients had persistent symptoms followed by repeated acute episodes; two showed a subacute onset with persistent symptoms; and two exhibited an insidious onset. Five patients made no attempt to avoid antigen exposure and they all had progressive disease. Pathological findings indicated that lesions were mainly centrilobular with or without epithelioid cell granulomas in specimens obtained during the acute or subacute stage. In contrast, most patients in the chronic stage predominantly showed interstitial fibrosis with a usual interstitial pneumonia pattern. Conclusions: The pathological findings of chronic HP depend on the stage of the disease at tissue sampling. [source] | ||||||||||