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Hypersensitivity pneumonitis

Huaqi Tang, Chunsheng Liu, Yanpeng Li, Xinyue Zhang, Guojie Xu
Fungi of the Alternaria genus are associated with allergic diseases, with Alternaria alternata being one of the most prevalent species. A. alternata has been frequently reported as the etiologic agent of hypersensitivity pneumonitis, allergic rhinosinusitis, bronchial asthma, and other diseases. In this study, we developed a loop-mediated isothermal amplification (LAMP) assay and a real-time PCR assay to detect low levels of A. alternata in herbal tea samples. The LAMP assay can detect as little as 3 pg/μL of A...
October 18, 2016: Journal of AOAC International
Chan Yeu Pu, Mohamed Rizwan Haroon Al Rasheed, Marin Sekosan, Vibhu Sharma
A 61-year-old man was evaluated for a 2 month history of cough and dyspnea without relevant exposures other than pyrethrin containing insecticidal sprays he used while grooming dogs almost daily. High Resolution Computed Tomography (HRCT) of the chest demonstrated a Non-Specific Interstitial Pneumonia (NSIP) pattern. Pulmonary function testing revealed an isolated mildly reduced diffusion capacity. Bronchoalveolar lavage (BAL) results confirmed the presence of foamy histiocytes, lymphocytes, and polymorphonuclear cells consistent with ongoing exposure...
October 17, 2016: American Journal of Industrial Medicine
Andrea L Magee, Steven M Montner, Aliya Husain, Ayodeji Adegunsoye, Rekha Vij, Jonathan H Chung
The management of hypersensitivity pneumonitis (HP) depends on early identification of the disease process, which is complicated by its nonspecific clinical presentation in addition to variable and diverse laboratory and radiologic findings. HP is the result of exposure and sensitization to myriad aerosolized antigens. HP develops in the minority of antigenic exposures, and conversely has been documented in patients with no identifiable exposure, complicating the diagnostic algorithm significantly. Prompt diagnosis and early intervention are critical in slowing the progression of irreversible parenchymal damage, and additionally in preserving the quality of life of affected patients...
November 2016: Radiologic Clinics of North America
Carlos Ac Pereira, Andréa Gimenez, Lilian Kuranishi, Karin Storrer
Hypersensitivity pneumonitis (HSP) is a common interstitial lung disease resulting from inhalation of a large variety of antigens by susceptible individuals. The disease is best classified as acute and chronic. Chronic HSP can be fibrosing or not. Fibrotic HSP has a large differential diagnosis and has a worse prognosis. The most common etiologies for HSP are reviewed. Diagnostic criteria are proposed for both chronic forms based on exposure, lung auscultation, lung function tests, HRCT findings, bronchoalveolar lavage, and biopsies...
2016: Journal of Asthma and Allergy
Sheetu Singh, Bridget F Collins, Bharat B Sharma, Jyotsna M Joshi, Deepak Talwar, Sandeep Katiyar, Nishtha Singh, Lawrence Ho, Jai Kumar Samaria, Parthasarathi Bhattacharya, Rakesh Gupta, Sudhir Chaudhari, Tejraj Singh, Vijay Moond, Sudhakar Pipavath, Jitesh Ahuja, Ravindran Chetambath, Aloke G Ghoshal, Nirmal K Jain, Hj Gayathri Devi, Surya Kant, Parvaiz Koul, Raja Dhar, Rajesh Swarnakar, Suresh Kumar Sharma, Dhrubajyoti J Roy, Kripesh R Sarmah, Bhavin Jankharia, Rodney Schmidt, Santosh K Katiyar, Arpita Jindal, Daya K Mangal, Virendra Singh, Ganesh Raghu
RATIONALE: Interstitial lung disease (ILD) is a heterogeneous group of acute and chronic inflammatory and fibrotic lung diseases. Existing ILD registries have had variable findings. Little is known about the profile of ILDs in India. OBJECTIVES: Create a prospective Registry with validation of diagnoses by multidisciplinary discussion (MDD) to characterize the clinical profile of new onset-ILD in India. METHODS: Prospective recruitment of adult patients with new onset ILD (27 centers in 19 Indian cities, 3/2012-6/2015) with connective tissue disease (CTD) serologies and high-resolution computed tomography (HRCT) chest...
September 29, 2016: American Journal of Respiratory and Critical Care Medicine
Kamonpun Ussavarungsi, Ryan M Kern, Anja C Roden, Jay H Ryu, Eric S Edell
BACKGROUND: Diagnostic evaluation of patients with diffuse parenchymal lung disease (DPLD) is best achieved by a multidisciplinary team correlating clinical, radiologic, and pathologic features. Surgical lung biopsies remain the gold standard for histopathologic diagnosis of idiopathic interstitial pneumonias. Emerging data suggest an increasing role for transbronchial cryobiopsy (TBC) in DPLD evaluation. We describe our experience with TBC in patients with DPLD. METHODS: We retrospectively reviewed medical records of patients with radiographic features of DPLD who underwent TBC at Mayo Clinic, Rochester, Minnesota in June 2013-September 2015...
September 19, 2016: Chest
Brandon T Larsen, Maxwell L Smith, Brett M Elicker, Jessica M Fernandez, Guillermo A Arbo-Oze de Morvil, Carlos A C Pereira, Kevin O Leslie
Context .- Idiopathic pulmonary fibrosis (IPF) is a distinctive clinicopathologic entity and the most common form of progressive diffuse lung scarring in older adults. Idiopathic pulmonary fibrosis manifests histopathologically as the usual interstitial pneumonia pattern. The usual interstitial pneumonia pattern is distinguished by geographically and temporally heterogeneous fibrosis that is peripherally accentuated, often with honeycombing and traction bronchiectasis. Idiopathic pulmonary fibrosis is not the only disease that leads to end-stage lung fibrosis, however, and several other entities may also cause advanced fibrosis...
September 15, 2016: Archives of Pathology & Laboratory Medicine
Małgorzata E Jędrych, Monika Szturmowicz, Iwona Bestry, Jan Kuś
Hypersensitivity pneumonitis (HP) is caused by inhalation of environmental antigens. Farmers and bird keepers are most frequently affected by this desease. The HP diagnosis is based on clinical symptoms (cough, dyspnea) in a person exposed to environmental antigens, and the presence of characteristic changes in high resolution chest computed tomography (HRCT) (bilateral, mosaic, ground glass opacities in the middle and lower lung zones, ill-defined centrilobular nodules and the sign of air-trapping on expiration)...
2016: Medycyna Pracy
Jason Raymond Woloski, Skye Heston, Sheyla Pamela Escobedo Calderon
Allergic asthma refers to a chronic reversible bronchoconstriction influenced by an allergic trigger, leading to symptoms of cough, wheezing, shortness of breath, and chest tightness. Allergic bronchopulmonary aspergillosis is a complex hypersensitivity reaction, often in patients with asthma or cystic fibrosis, occurring when bronchi become colonized by Aspergillus species. The clinical picture is dominated by asthma complicated by recurrent episodes of bronchial obstruction, fever, malaise, mucus production, and peripheral blood eosinophilia...
September 2016: Primary Care
Chad A Newton, Kiran Batra, Jose Torrealba, Julia Kozlitina, Craig S Glazer, Carlos Aravena, Keith Meyer, Ganesh Raghu, Harold R Collard, Christine Kim Garcia
Heterozygous mutations in four telomere-related genes have been linked to pulmonary fibrosis, but little is known about similarities or differences of affected individuals.115 patients with mutations in telomerase reverse transcriptase (TERT) (n=75), telomerase RNA component (TERC) (n=7), regulator of telomere elongation helicase 1 (RTEL1) (n=14) and poly(A)-specific ribonuclease (PARN) (n=19) were identified and clinical data were analysed.Approximately one-half (46%) had a multidisciplinary diagnosis of idiopathic pulmonary fibrosis (IPF); others had unclassifiable lung fibrosis (20%), chronic hypersensitivity pneumonitis (12%), pleuroparenchymal fibroelastosis (10%), interstitial pneumonia with autoimmune features (7%), an idiopathic interstitial pneumonia (4%) and connective tissue disease-related interstitial fibrosis (3%)...
August 18, 2016: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Gilles Rival, Philippe Manzoni, Yves Lacasse, Jean Charles Polio, Virginie Westeel, André Dubiez, Thibaud Soumagne, François Laurent, Jean Charles Dalphin
BACKGROUND: The purpose of this study was to evaluate the use of high-resolution chest computed tomography (HRCT) to distinguish hypersensitivity pneumonitis (HP) from other diffuse parenchymal lung diseases (DPLDs). METHODS: We examined 130 consecutive patients admitted to our hospital with DPLDs proved by HRCT. Patients underwent clinical and paraclinical examinations. Two readers interpreted 111 HRCT scans using predefined criteria. RESULTS: The findings in patients with HP were compared to those with other DPLDs (non-HP) by univariate and multivariate analyses...
2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Paweł Wojtan, Michał Mierzejewski, Iwona Osińska, Joanna Domagała-Kulawik
The role of bronchoalveolar lavage fluid (BALf) examination in differential diagnosis of interstitial lung diseases (ILD) was established. Currently, functional polarization into M1 (pro-inflammatory) and M2 (anti-inflammatory) subpopulations is emphasized. The aim of our study was to compare the proportion of M1 and M2 in BALf of patients with different ILD. BALf samples were collected from 75 ILD patients: sarcoidosis (SA, 36), hypersensitivity pneumonitis (HP, 10), non-specific interstitial pneumonia (NSIP, 8), idiopathic pulmonary fibrosis (IPF, 6) and other ILD (15)...
2016: Central-European Journal of Immunology
Mizuki Nishino, Nikhil H Ramaiya, Mark M Awad, Lynette M Sholl, Jennifer A Maattala, Myriam Taibi, Hiroto Hatabu, Patrick A Ott, Philippe Armand, F Stephen Hodi
PURPOSE: Investigate the clinical characteristics, radiographic patterns, and treatment course of PD-1 inhibitor-related pneumonitis in advanced cancer patients. EXPERIMENTAL DESIGN: Among patients with advanced melanoma, lung cancer, or lymphoma treated in trials of nivolumab, we identified those who developed pneumonitis. Chest CT scans were reviewed to assess extent, distribution, and radiographic patterns of pneumonitis. RESULTS: Among 170 patients treated in 10 different trials of nivolumab, 20 patients (10 melanoma, 6 lymphoma, 4 lung cancer) developed pneumonitis...
August 17, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Choong Yi Fong, Nurmaira Hashim, Chin Seng Gan, Tak Kuan Chow, Chee Geap Tay
BACKGROUND: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially life-threatening acute drug-induced hypersensitivity reaction. Antiepileptic drugs (AEDs) predominantly aromatic AEDs are commonly reported in DRESS. To date there are no reports of sulthiame AED causing DRESS syndrome. METHOD: We report a 10-year-old girl of Indian descent with AED resistant epilepsy on maintenance sodium valproate and clonazepam. Sulthiame AED was initiated to try to improve her seizure control...
November 2016: European Journal of Paediatric Neurology: EJPN
Ayodeji Adegunsoye, Mary E Strek
Among the interstitial lung diseases (ILD), idiopathic pulmonary fibrosis (IPF), chronic hypersensitivity pneumonitis and fibrotic connective tissue disease related ILD are associated with a worse prognosis with death occurring both from respiratory failure and serious associated co-morbidities. The recent development and approval of the antifibrotic agents nintedanib and pirfenidone, both of which reduced the rate of decline in lung function in patients with IPF in clinical trials, offer hope that it may be possible to alter the increased mortality associated with IPF...
August 10, 2016: Chest
L Millon, B Rognon, B Valot, C Barrera, A P Bellanger, S Roussel, J D Dalphin, M Monod, G Reboux
The identification of common epitopes in orthologous immunogenic proteins from two microorganisms belonging to very different phylogenetic families, each involved in a specific form of HP, could help in developing new diagnostic and therapeutic strategies.
August 3, 2016: Journal of Allergy and Clinical Immunology
P Sherwood Burge
PURPOSE OF REVIEW: This review summarises the clinical knowledge of hypersensitivity pneumonitis in workers exposed to aerosols of metalworking fluid, reviewing published outbreaks and clinical cases. RECENT FINDINGS: Metalworking fluid exposure has become the commonest recognised cause of occupational hypersensitivity pneumonitis, having been rare before 2000. There are many possible agents in the metalworking fluid which may be the cause of disease including bacteria, mycobacteria, fungae, biocides, emulsifiers, reodorants and dissolved chrome and cobalt...
August 2016: Current Allergy and Asthma Reports
Biqing Yu, Xiaohong Yang, Fengsen Li, Chao Wu, Wenyi Wang, Wei Ding
Pigeon breeder's lung (PBL) is a type of lung inflammatory disease associated with the immune response to repeated pigeon-derived antigen exposure. The pathogenesis of PBL remains unclear. In this study, peripheral blood samples were collected from Uygur acute - and chronic-phase PBL patients and healthy subjects with pigeon contact. Foxp3+CD4+ regulatory T cell (Treg) activity in different phases of PBL was characterized by changes in Foxp3+CD4+ Treg, CD4+CD25+ T cell, and T lymphocyte subsets. Based on hypersensitivity pneumonitis (HP) diagnosis criteria, 32 PBL cases from January 2012 to December 2013 in the People's Hospital of Xinjiang Uygur Autonomous Region Respiratory Department were included...
July 23, 2016: Bosnian Journal of Basic Medical Sciences
Thibaud Soumagne, Gabriel Reboux, Bruno Degano, Jean Charles Dalphin
A 52-year-old non-smoking beautician using a skincare device spraying steam and ozone (a "vapozone" facial steamer) was referred for progressive dyspnea and dry cough during working periods. Although spirometry was normal, she had decreased diffusing capacity of the lung for carbon monoxide, bronchiolitis with air trapping on high-resolution CT scan and 60% lymphocytosis by bronchoalveolar lavage. Twenty-six antigens were tested and serum-specific precipitins were found mainly against Pseudomonas sp. and Mycobacterium mucogenicum...
July 18, 2016: American Journal of Industrial Medicine
Semiha Bahçeci Erdem, Hikmet Tekin Nacaroğlu, Canan Şule Ünsal Karkıner, Güner Özçelik, Nesrin Mogulkoç, Hüdaver Alper, Demet Can
Bird fancier's lung (BFL), also called bird-breeder's lung or pigeon-breeder's disease (PBD), is a hypersensitivity pneumonitis (HP) that is rare in children. A 9-year-old male patient complained of cough, dyspnea and chest pain, in his examination his lips were cyanosed and his SaO2 was 86% at room air. Bilateral crepitant rales and sibilant rhochi were also detected. In his thoracic computerized tomography, the ground glass areas were noted in both lungs. In his medical history, it was discovered that he lived above an office in which birds and bird manure were merchandised...
September 2015: Turkish Journal of Pediatrics
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